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Petrović V, Čanković S. Prevalence of obesity and impact of socio-demographic factors on obesity in 15-19 years old adolescents in Vojvodina, Serbia. Cent Eur J Public Health 2023; 31:287-295. [PMID: 38309707 DOI: 10.21101/cejph.a7683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 11/14/2023] [Indexed: 02/05/2024]
Abstract
OBJECTIVES The aim of this study was to examine the prevalence of overweight/obesity in 15-19 years old adolescents in the Province of Vojvodina, Serbia, and to evaluate the association between obesity and socio-demographic factors. METHODS A cross-sectional study was conducted in high schools in the territory of Vojvodina, Serbia. The sample consisted of 986 high-school students (47.4% girls and 52.6% boys). Body height, body weight, and waist circumference were measured. Obesity was defined as a body mass index (BMI)-for-age value > x̅ + 2 SD, and overweight as a BMI-for-age value > x̅ + 1 SD and ≤ x̅ + 2 SD. Waist-to-height ratio (WHtR) of ≥ 0.5 was considered high risk. Socio-demographic data was collected using a questionnaire developed for this study. Univariate and multivariate logistic regression analyses were implemented. RESULTS The prevalence of overweight and obesity in adolescents was 19.6% and 10.1%, respectively. Boys were more likely to be obese than girls (OR = 1.87; 95% CI: 1.37-2.56). Adolescents living in suburban areas had a greater chance of obesity compared to those living in urban areas (OR = 1.84; 95% CI: 1.15-2.94), as well as those who attended trade schools compared to gymnasium students (OR = 1.92; 95% CI: 1.20-3.07). The lower level of the father's education was a significant predictor of obesity. Predictors of high-risk WHtR were gender, high school type, and the father's education level. CONCLUSIONS Obesity and abdominal obesity are highly prevalent in adolescents in Vojvodina, more in boys. Gender, community type and the level of the father's education were confirmed as significant factors that influenced both obesity and abdominal obesity. This study could help to customize health promotion policies for adolescents in Vojvodina.
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Affiliation(s)
- Vesna Petrović
- Primary Health Care Centre "Dr Milorad Mika Pavlovic", Indjija, Serbia
| | - Sonja Čanković
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
- Centre for Analysis, Planning and Organization of Health Care, Institute of Public Health of Vojvodina, Novi Sad, Serbia
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Baek HS, Park MJ, Song JY, Kim SH, Kang HG, Ahn YH, Han KH, Cho H, Lee KH, Shin JI, Park YS, Lee JH, Park E, Yang EM, Cho MH. Association between serum total cholesterol and chronic kidney disease progression in children: results from the KNOW-PedCKD. Pediatr Nephrol 2023; 38:4101-4109. [PMID: 37338642 DOI: 10.1007/s00467-023-06033-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 05/17/2023] [Accepted: 05/19/2023] [Indexed: 06/21/2023]
Abstract
BACKGROUND Dyslipidemia can cause cardiovascular disease and increase the fatality rate among children with chronic kidney disease (CKD); this makes early screening and treatment of dyslipidemia crucial. This study aimed to assess the association between the changes in serum total cholesterol levels over time and the degree of CKD progression in children. METHODS From April 2011 to August 2021, 379 of the 432 participants enrolled in the KoreaN cohort study for Outcomes in patients With Pediatric CKD (KNOW-PedCKD) were included and divided into 4 categories based on total cholesterol levels (< 170 mg/dL, acceptable; 170-199, borderline; 200-239, high; and ≥ 240, very high). Survival analysis using conventional and time-dependent Cox proportional hazards model were performed for a composite event of CKD progression (≥ 50% decrease in estimated glomerular filtration rate from baseline, a twofold increase in creatinine, or the occurrence of dialysis or kidney transplantation). RESULT The incidence of composite event of CKD progression was 96.3, 90.4, 87.3, and 270.6 cases per 1000 person-years in the acceptable, borderline, high, and very high categories, respectively. On using the time-dependent Cox proportional hazards model, the hazard ratio of the very high category was significantly higher than that of the acceptable category by 3.13 times as per univariate analysis and 2.37 times as per multivariate analysis. CONCLUSIONS Very high serum total cholesterol is a significant risk factor for CKD progression in children. Lowering total cholesterol levels below the very high category in children with CKD may delay the progression of CKD. A higher resolution version of the Graphical abstract is available as Supplementary information.
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Affiliation(s)
- Hee Sun Baek
- Department of Pediatrics, Yeungnam University, College of Medicine, Daegu, South Korea
| | - Min Ji Park
- Department of Pediatrics, Kyungpook National University, School of Medicine, Daegu, South Korea
| | - Ji Yeon Song
- Department of Pediatrics, Pusan National University Children's Hospital, Pusan National University, School of Medicine, Busan, South Korea
| | - Seong Heon Kim
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul, South Korea
| | - Hee Gyung Kang
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul, South Korea
| | - Yo Han Ahn
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul, South Korea
| | - Kyoung Hee Han
- Department of Pediatrics, Jeju National University Hospital, Jeju, South Korea
| | - Heeyeon Cho
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Keum Hwa Lee
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea
| | - Young Seo Park
- Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, South Korea
| | - Joo Hoon Lee
- Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, South Korea
| | - Eujin Park
- Department of Pediatrics, Korea University Guro Hospital, Korea University College of Medicine, Seoul, South Korea
| | - Eun Mi Yang
- Department of Pediatrics, Chonnam National University Hospital, Gwangju, South Korea
| | - Min Hyun Cho
- Department of Pediatrics, Kyungpook National University, School of Medicine, Daegu, South Korea.
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Shi S, Huang H, Huang Y, Zhong VW, Feng N. Lifestyle Behaviors and Cardiometabolic Diseases by Race and Ethnicity and Social Risk Factors Among US Young Adults, 2011 to 2018. J Am Heart Assoc 2023; 12:e028926. [PMID: 37608770 PMCID: PMC10547329 DOI: 10.1161/jaha.122.028926] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 07/20/2023] [Indexed: 08/24/2023]
Abstract
Background Cardiometabolic health has been worsening among young adults, but the prevalence of lifestyle risk factors and cardiometabolic diseases is unclear. Methods and Results Adults aged 18 to 44 years were included from the National Health and Nutrition Examination Survey, 2011 to 2018. Age-standardized prevalence of lifestyle risk factors and cardiometabolic diseases was estimated overall and by demographic and social risk factors. A set of multivariable logistic regressions was sequentially performed by adjusting for age, sex, social risk factors, and lifestyle factors to determine whether racial and ethnic disparities in the prevalence of cardiometabolic diseases may be attributable to differences in social risk factors and lifestyle factors. Appropriate weights were used to ensure national representativeness of the estimates. A total of 10 405 participants were analyzed (median age, 30.3 years; 50.8% women; 32.3% non-Hispanic White). The prevalence of lifestyle risk factors ranged from 16.3% for excessive drinking to 49.3% for poor diet quality. The prevalence of cardiometabolic diseases ranged from 4.3% for diabetes to 37.3% for dyslipidemia. The prevalence of having ≥2 lifestyle risk factors was 45.2% and having ≥2 cardiometabolic diseases was 22.0%. Racial and ethnic disparities in many cardiometabolic diseases persisted but were attenuated after adjusting for social risk factors and lifestyle factors. Conclusions The prevalence of lifestyle risk factors and cardiometabolic diseases was high among US young adults and varied by race and ethnicity and social risk factors. Racial and ethnic disparities in the prevalence of cardiometabolic diseases were not fully explained by differences in social risk factors and lifestyle factors.
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Affiliation(s)
- Shuxiao Shi
- Department of Epidemiology and Biostatistics, School of Public HealthShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Hengye Huang
- Department of Epidemiology and Biostatistics, School of Public HealthShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Yue Huang
- Department of Epidemiology and Biostatistics, School of Public HealthShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Victor W. Zhong
- Department of Epidemiology and Biostatistics, School of Public HealthShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Nannan Feng
- Department of Epidemiology and Biostatistics, School of Public HealthShanghai Jiao Tong University School of MedicineShanghaiChina
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Ukegbu TE, Wylie-Rosett J, Groisman-Perelstein AE, Diamantis PM, Rieder J, Ginsberg M, Lichtenstein AH, Matthan NR, Shankar V. Waist-to-height ratio associated cardiometabolic risk phenotype in children with overweight/obesity. BMC Public Health 2023; 23:1549. [PMID: 37582739 PMCID: PMC10426079 DOI: 10.1186/s12889-023-16418-9] [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: 10/31/2022] [Accepted: 07/28/2023] [Indexed: 08/17/2023] Open
Abstract
BACKGROUND Childhood overweight/obesity has been associated with an elevated risk of insulin resistance and cardiometabolic disorders. Waist-to-height ratio (WHtR) may be a simple screening tool to quickly identify children at elevated risk for cardiometabolic disorders. The primary objective of the present study was to create sex-specific tertile cut points of WHtR and assess its association with Insulin resistance and elevated liver enzyme concentrations in children, factors using cross-sectional data from the randomized, controlled Family Weight Management Study. METHODS Baseline data from 360 children (7-12 years, mean Body Mass Index (BMI) ≥ 85th percentile for age and sex) were used to calculate WHtR tertiles by sex, male: ≤ 0.55 (T1), > 0.55- ≤ 0.59 (T2), > 0.59 (T3); female: ≤ 0.56 (T1), > 0.56- ≤ 0.6 (T2), > 0.6 (T3). The Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) was used to categorize participants as insulin-resistant (HOMA-IR ≥ 2.6) and insulin-sensitive (HOMA-IR < 2.6). Liver enzymes aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were categorized as normal vs. elevated (AST of < 36.0 µkat/L or ≥ 36.0 µkat/L; ALT of < 30.0 µkat/L or ≥ 30.0 µkat/L; ALT > 26 µkat/L males, > 22 µkat/L females). We examined differences in baseline cardiometabolic risk factors by WHtR tertiles and sex-specific multivariable logistic regression models to predict HOMA-IR and elevation of liver enzymes. RESULTS Study participants had a mean WHtR of 0.59 ([SD: 0.06]). Irrespective of sex, children in WHtR T3 had higher BMIz scores, blood pressure, triglycerides, 2-h glucose, fasting 2-h insulin, and lower high-density lipoprotein cholesterol (HDL-C) concentrations than those in T2 and T1. After adjusting for covariates, the odds of elevated HOMA-IR (> 2.6) were over five-fold higher among males in T3 versus T1 [OR, 95%CI: 5.83, 2.34-14.52] and T2 [OR, 95%CI: 4.81, 1.94-11.92] and females in T3 [OR, 95%CI: 5.06, 2.10-12.20] versus T1. The odds of elevated ALT values (≥ 30) were 2.9 [95%CI: 1.01-8.41] fold higher among females in T3 compared to T1. CONCLUSION In public health settings, WHtR may be a practical screening tool in pediatric populations to identify children at risk of metabolic syndrome.
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Affiliation(s)
- Tochi E Ukegbu
- Sophie Davis School of Biomedical Education, The City College of New York, 160 Convent Ave, New York, NY, 10031, USA
| | - Judith Wylie-Rosett
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY, 10461, USA
| | - Adriana E Groisman-Perelstein
- Department of Pediatrics, Albert Einstein College of Medicine, Jacobi Medical Center, NY, 10461, Pelham Pkwy S, Bronx, USA
| | - Pamela M Diamantis
- Department of Pediatrics, Albert Einstein College of Medicine, Jacobi Medical Center, NY, 10461, Pelham Pkwy S, Bronx, USA
| | - Jessica Rieder
- Department of Pediatrics, Albert Einstein College of Medicine Children's Hospital at Montefiore, Bronx, NY, 10467, USA
| | - Mindy Ginsberg
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY, 10461, USA
| | - Alice H Lichtenstein
- Cardiovascular Nutrition Laboratory, JM USDA Human Nutrition Research Center on Aging, Tufts University, 711 Washington St, MA, 02111, Boston, USA
| | - Nirupa R Matthan
- Cardiovascular Nutrition Laboratory, JM USDA Human Nutrition Research Center on Aging, Tufts University, 711 Washington St, MA, 02111, Boston, USA
| | - Viswanathan Shankar
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY, 10461, USA.
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Chung ST, Krenek A, Magge SN. Childhood Obesity and Cardiovascular Disease Risk. Curr Atheroscler Rep 2023:10.1007/s11883-023-01111-4. [PMID: 37256483 DOI: 10.1007/s11883-023-01111-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2023] [Indexed: 06/01/2023]
Abstract
PURPOSE OF REVIEW The global epidemic of youth-onset obesity is tightly linked to the rising burden of cardiometabolic disease across the lifespan. While the link between childhood obesity and cardiovascular disease is established, this contemporary review summarizes recent and novel advances in this field that elucidate the mechanisms and impact of this public health issue. RECENT FINDINGS The review highlights the emerging data supporting the relationship between childhood adverse events, social determinants of health, and systemic and institutional systems as etiological factors. We also provide updates on new screening and treatment approaches including updated nutrition and dietary guidelines and benchmarks for pediatric obesity screening, novel pharmacological agents for pediatric obesity and type 2 diabetes such as glucagon-like 1 peptide receptor agonists, and we discuss the long-term safety and efficacy data on surgical management of pediatric obesity. The global burden of pediatric obesity continues to rise and is associated with accelerated and early vascular aging especially in youth with obesity and type 2 diabetes. Socio-ecological determinants of risk mediate and moderate the relationship of childhood obesity with cardiometabolic disease. Recognizing the importance of neighborhood level influences as etiological factors in the development of cardiovascular disease is critical for designing effective policies and interventions. Novel surgical and pharmacological interventions are effective pediatric weight-loss interventions, but future research is needed to assess whether these agents, within a socio-ecological framework, will be associated with abatement of the pediatric obesity epidemic and related increased cardiovascular disease risk.
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Affiliation(s)
- Stephanie T Chung
- Section on Pediatric Diabetes and Metabolism, National Institute of Diabetes & Digestive & Kidney Disease, NIH Bethesda, Bethesda, MD, USA
| | - Andrea Krenek
- Section on Pediatric Diabetes and Metabolism, National Institute of Diabetes & Digestive & Kidney Disease, NIH Bethesda, Bethesda, MD, USA
| | - Sheela N Magge
- Division of Pediatric Endocrinology and Diabetes, Johns Hopkins University School of Medicine, 200 N. Wolfe Street, Rubenstein Bldg, Rm 3114, Baltimore, MD, 21287, USA.
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Baxter JAB, Wasan Y, Hussain A, Soofi SB, Ahmed I, Bhutta ZA. Drivers of malnutrition among late adolescent and young women in rural Pakistan: a cross-sectional assessment of the MaPPS trial. BMJ Open 2023; 13:e063734. [PMID: 37221027 DOI: 10.1136/bmjopen-2022-063734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/25/2023] Open
Abstract
OBJECTIVE This study aimed to characterise the burden of malnutrition and assess how underlying determinants at the structural and intermediary levels contributed to malnutrition among late adolescent and young women in rural Pakistan. DESIGN Cross-sectional enrolment data assessment. SETTING AND PARTICIPANTS This study was conducted using data from adolescent and young women (n=25 447) enrolled in the Matiari emPowerment and Preconception Supplementation Trial, collected from June 2017 to July 2018 in Matiari District, Pakistan. The WHO-based cut-offs were applied to anthropometric measures to estimate body mass index (BMI) categories (underweight, overweight, obese) and stunting. Hierarchical models were generated to evaluate the association between the determinants with BMI categories and stunting among late adolescent girls and young women, respectively. PRIMARY AND SECONDARY OUTCOME MEASURES The main outcomes of interest were BMI categories and stunting. Explanatory variables included measures of socioeconomic status, education, occupation, health, well-being, food security, empowerment and food practices. RESULTS Regardless of age group, the prevalence of underweight was high (36.9%; 95% CI 36.3% to 37.5%). More late adolescent girls were underweight, while more young women were overweight/obese (p<0.001). Stunting affected 9.2% (95% CI 8.9% to 9.6%) of participants, of which 35.7% were additionally underweight and 7.3% overweight/obese. Compared with those in the normal weight category, those underweight were more likely to be impoverished and less empowered. Those overweight/obese were more likely to be from a higher wealth quintile and food secure. Increased education level and food security were associated with reductions stunting risk. CONCLUSIONS This study informs the data gap and need for comprehensive research on adolescent nutritional status. Findings suggest factors related to poverty played an important, underlying role in undernutrition among participants. Commitment to improving the nutritional status of all adolescent and young women in Pakistan will be critical given the observed burden of malnutrition. TRIAL REGISTRATION NUMBER NCT03287882.
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Affiliation(s)
- Jo-Anna B Baxter
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Yaqub Wasan
- Centre of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan
| | - Amjad Hussain
- Centre of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan
| | - Sajid B Soofi
- Centre of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan
| | - Imran Ahmed
- Centre of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan
| | - Zulfiqar A Bhutta
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
- Centre of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan
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Klappenbach CM, Wang Q, Jensen AL, Glodosky NC, Delevich K. Sex and timing of gonadectomy relative to puberty interact to influence weight, body composition, and feeding behaviors in mice. Horm Behav 2023; 151:105350. [PMID: 36996734 DOI: 10.1016/j.yhbeh.2023.105350] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 03/14/2023] [Accepted: 03/17/2023] [Indexed: 04/01/2023]
Abstract
Gonadal sex steroids are important regulators of energy balance in adult rodents, and gonadectomy (GDX) has opposing effects on weight gain in sexually mature males and females. Puberty is associated with the emergence of sex differences in weight, body composition, and feeding behaviors, yet the role of gonadal hormones at puberty remains unclear. To address this, we performed GDX or sham surgery in male and female C57Bl/6 mice at postnatal day (P)25 (prepubertal) or P60 (postpubertal) timepoints and measured weight and body composition for 35 days, after which ad libitum and operant food intake was measured using Feeding Experimentation Device 3 (FED3s) in the home cage. Consistent with previous studies, postpubertal GDX caused weight gain in females and weight loss in males and increased adiposity in both sexes. However, prepubertal GDX decreased weight gain and altered body composition across the adolescent transition (P25 to P60) in males but had no effect in females. Despite the varied effects on weight, GDX decreased food intake and motivation for food as assessed in operant tasks regardless of sex or timing of surgery relative to puberty. Our findings indicate that GDX interacts with both sex and age at surgery to influence weight, body composition, and feeding behavior.
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Affiliation(s)
- Courtney M Klappenbach
- Department of Integrative Physiology and Neuroscience, Washington State University, Pullman, WA 99164, USA
| | - Qing Wang
- Department of Integrative Physiology and Neuroscience, Washington State University, Pullman, WA 99164, USA
| | - Allison L Jensen
- Department of Integrative Physiology and Neuroscience, Washington State University, Pullman, WA 99164, USA
| | - Nicholas C Glodosky
- Department of Psychology Washington State University, Pullman, WA 99164, USA
| | - Kristen Delevich
- Department of Integrative Physiology and Neuroscience, Washington State University, Pullman, WA 99164, USA.
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Eslami M, Pourghazi F, Khazdouz M, Tian J, Pourrostami K, Esmaeili-Abdar Z, Ejtahed HS, Qorbani M. Optimal cut-off value of waist circumference-to-height ratio to predict central obesity in children and adolescents: A systematic review and meta-analysis of diagnostic studies. Front Nutr 2023; 9:985319. [PMID: 36687719 PMCID: PMC9846615 DOI: 10.3389/fnut.2022.985319] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 12/12/2022] [Indexed: 01/06/2023] Open
Abstract
Introduction Waist circumference-to-height ratio (WHtR) is a simple anthropometric index with good screening power and fast interpretation for early detection of childhood abdominal obesity. This systematic review and meta-analysis aims to determine the best cut-off value of WHtR to use in clinical setting. Methods Comprehensive searches were conducted in PubMed, Scopus, and Web of Science by the end of March 2021. Observational studies investigated the best WHtR cut-off to detect abdominal obesity in children and adolescents were included. Thirteen articles (n = 180,119) were included in this systematic review and eight documents were included in the meta-analysis. Results The overall optimal cut-off was 0.49 with pooled sensitivity, specificity and diagnostic odds ratio (DOR) of 0.93 (95% confidence interval (CI): 0.93-0.96), 0.88 (95% CI: 0.85-0.91) and 102.6 (95% CI: 50.7-207.5), respectively. The optimal WHtR cut-off to predict abdominal obesity in girls and boys were both 0.49. Discussion The current study shows that we could use this cut-off as a simple index for predicting abdominal obesity in children and adolescents without the need for any charts in practice.
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Affiliation(s)
- Maysa Eslami
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzad Pourghazi
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Khazdouz
- Growth and Development Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Jing Tian
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Kumars Pourrostami
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Zahra Esmaeili-Abdar
- Dietary Supplements and Probiotic Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Hanieh-Sadat Ejtahed
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mostafa Qorbani
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Liu C, Pang K, Tong J, Ouyang W, Li L, Tang Y. The association between hemoglobin A1c and all-cause mortality in the ICU: A cross-section study based on MIMIC-IV 2.0. Front Endocrinol (Lausanne) 2023; 14:1124342. [PMID: 36875458 PMCID: PMC9975393 DOI: 10.3389/fendo.2023.1124342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 01/31/2023] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND Hyperglycemia has been reported to be associated with the outcomes of patients in the intensive care unit (ICU). However, the relationship between hemoglobin A1c (HbA1c) and long-term or short-term mortality in the ICU is still unknown. This study used the Medical Information Mart for Intensive Care (MIMIC)-IV database to investigate the relationship between HbA1c and long-term or short-term mortality among ICU patients without a diabetes diagnosis. METHODS A total of 3,154 critically ill patients without a diabetes diagnosis who had HbA1c measurements were extracted and analyzed from the MIMIC-IV. The primary outcome was 1-year mortality, while the secondary outcomes were 30-day mortality and 90-day mortality after ICU discharge. HbA1c levels were classified into four levels according to three HbA1c values (5.0%, 5.7%, and 6.5%). The Cox regression model was used to investigate the relationship between the highest HbA1c measurement and mortality. Finally, this correlation was validated using the XGBoost machine learning model and Cox regression after propensity score matching (PSM). RESULTS The study eventually included 3,154 critically ill patients without diabetes who had HbA1c measurements in the database. HbA1c levels of below 5.0% or above 6.5% were significantly associated with 1-year mortality after adjusting for covariates in Cox regression (HR: 1.37; 95% CI: 1.02-1.84 or HR: 1.62; 95% CI: 1.20-2.18). In addition, HbA1c 6.5% was linked to 30-day mortality (HR: 1.81; 95% CI: 1.21-2.71) and 90-day mortality (HR: 1.62; 95% CI: 1.14-2.29). The restricted cubic spline demonstrated a U-shaped relationship between HbA1c levels and 1-year mortality. The AUCs of the training and testing datasets in the XGBoost model were 0.928 and 0.826, respectively, while the SHAP plot revealed that HbA1c was somewhat important for the 1-year mortality. Higher HbA1c levels in Cox regression were still significantly associated with 1-year mortality after PSM for other factors. CONCLUSIONS The 1-year mortality, 30-day mortality, and 90-day mortality rates for critically ill patients after discharge from ICU are significantly associated with HbA1c. HbA1c < 5.0% and ≥6.5% would increase 30-day, 90-day, and 1-year mortality, while levels between 5.0% and 6.5% of HbA1c did not significantly affect these outcomes.
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Affiliation(s)
- Chunxia Liu
- Department of Anesthesiology, Third Xiangya Hospital, Central South University, Changsha, China
| | - Ke Pang
- Department of Anesthesiology, Third Xiangya Hospital, Central South University, Changsha, China
| | - Jianbin Tong
- Department of Anesthesiology, Third Xiangya Hospital, Central South University, Changsha, China
| | - Wen Ouyang
- Department of Anesthesiology, Third Xiangya Hospital, Central South University, Changsha, China
| | - Liang Li
- Department of Gastrointestinal Surgery, Third Xiangya Hospital, Central South University, Changsha, China
| | - Yongzhong Tang
- Department of Anesthesiology, Third Xiangya Hospital, Central South University, Changsha, China
- *Correspondence: Yongzhong Tang,
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Julia C, Omorou A, Lecomte E, Langlois J, Touvier M, Hercberg S, Briançon S, Kesse-Guyot E, Guillemin F. Behavioural risk patterns in adolescents with excess weight participating in the PRALIMAP-INÈS trial. Public Health Nutr 2023; 26:96-105. [PMID: 35272723 PMCID: PMC11077442 DOI: 10.1017/s136898002200057x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 03/01/2022] [Accepted: 03/09/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To investigate clustering of risk behaviours in adolescents with excess weight. DESIGN Cross-sectional analysis of baseline data from the PRALIMAP-INÈS trial. Information on food frequency consumption (fruit, vegetables, sugary products and beverages), physical activity, sedentary behaviour (week and weekend days), smoking and alcohol consumption (current frequency and intoxication episodes) and socio-demographic data was collected using self-reported questionnaires. Behavioural risk factors were entered as categorical variables in a two-step clustering procedure: multiple correspondence analysis followed by hierarchical clustering. Associations between cluster membership and socio-demographic variables were investigated using multivariable multinomial logistic regression. SETTING French PRALIMAP-INÈS trial. PARTICIPANTS Adolescents with excess weight. RESULTS A total of 1391 participants (13-18 years old, 58·2 % female) were included in the analysis, which resulted in the identification of four groups of participants, including, respectively, 543 (39·0 %), 373 (26·8 %), 246 (17·7 %) and 229 (16·5 %) participants. Clusters 1 and 4 showed associations of rather healthy behaviours (high physical activity and low consumption of sugary products; high consumption of fruit and vegetables, respectively), while clusters 2 and 3 showed associations of rather unhealthy behaviours (high sedentary behaviour and low consumption of fruit and vegetables; smoking and alcohol consumption, respectively). Both social status and family structure were associated with cluster membership. CONCLUSIONS Risk behaviour patterns in adolescents with excess weight were clustered in both healthier and less healthy ways, with a complex interplay with socio-demographic factors.
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Affiliation(s)
- Chantal Julia
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), Bobigny, France
- Public Health Department, Avicenne Hospital, Bobigny, France
- University of Lorraine, EA 4360 APEMAC, Nancy, France
| | - Abdou Omorou
- University of Lorraine, EA 4360 APEMAC, Nancy, France
- CHRU-Nancy, INSERM, University of Lorraine, CIC-1433 Clinical Epidemiology, Nancy, France
| | - Edith Lecomte
- National Conservatory of Arts and Crafts, Nancy, France
| | | | - Mathilde Touvier
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), Bobigny, France
| | - Serge Hercberg
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), Bobigny, France
- Public Health Department, Avicenne Hospital, Bobigny, France
| | | | - Emmanuelle Kesse-Guyot
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), Bobigny, France
| | - Francis Guillemin
- University of Lorraine, EA 4360 APEMAC, Nancy, France
- CHRU-Nancy, INSERM, University of Lorraine, CIC-1433 Clinical Epidemiology, Nancy, France
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11
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Zhang F, Han Y, Wang H, Li Y, Yan Z. Diagnostic test accuracy of waist-to-height ratio as a screening tool for cardiovascular risk in children and adolescents: a meta-analysis. Ann Hum Biol 2022; 49:217-227. [PMID: 36121693 DOI: 10.1080/03014460.2022.2126523] [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: 01/04/2023]
Abstract
CONTEXT Waist-to-height ratio (WHtR) is a controversial evaluation index of cardiovascular risk factors (CVRFs) in children and adolescents. OBJECTIVE To assess the accuracy of WHtR as a measure to screen for clusters of at least one CVRF (CVRF1), two CVRFs (CVRF2), and three CVRFs (CVRF3) in different ages, sexes, regions and cut-offs. METHODS The PubMed, Web of Science, EBSCOhost, Springer, Taylor & Francis Online, Wiley Online Library, Wanfang, and CNKI databases were searched for eligible publications up to June 2021. The QUADAS-2 checklist was used to assess the methodology of the included studies. RESULTS Twenty-two studies that evaluated 85281 children and adolescents aged 5-19 years were included in the meta-analysis. The AUSROC values were 0.56 (95% CI: 0.54-0.57), 0.82 (95% CI: 0.81-0.83), and 0.89 (95% CI: 0.89-0.90) for CVRF1, CVRF2, and CVRF3, respectively. Higher AUSROC values were found for adolescents (12-19 years), that is, 0.91 (95% CI: 0.88-0.93), 0.90 (95% CI: 0.87-0.92) for males, and 0.91 (95% CI: 0.90-0.91) for a cut-off of ≥ 0.51 in the identification of CVRF3. CONCLUSION WHtR can be used as an accurate screening tool for CVRF3 and CVRF2 in children and adolescents, and it is recommended to select different cut-offs according to different ages, sexes, and regions.
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Affiliation(s)
- Fusheng Zhang
- College of Physical Education and Health, Guangxi Normal University, Guilin, China.,School of Physical Education, Zhaotong University, Zhaotong, China
| | - Yanbai Han
- College of Physical Education and Health, Guangxi Normal University, Guilin, China
| | - Hongli Wang
- College of Physical Education and Health, Guangxi Normal University, Guilin, China
| | - Yong Li
- College of Physical Education and Health, Guangxi Normal University, Guilin, China
| | - Zhiwei Yan
- Department of Sports Rehabilitation, College of Human Kinesiology, Shenyang Sport University, Shenyang, China
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12
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Wickrama KAS, Wickrama T, Bae D, Merten M. Early socioeconomic adversity and young adult diabetic risk: an investigation of genetically informed biopsychosocial processes over the life course. BIODEMOGRAPHY AND SOCIAL BIOLOGY 2022; 67:203-223. [PMID: 36573270 DOI: 10.1080/19485565.2022.2161463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
The present study investigated a comprehensive model that integrates contributions of early socioeconomic adversity (ESA) and multiple polygenic scores (PGSs) through different mechanisms leading to diabetic risk in early adulthood. The study used prospective, longitudinal data from the National Longitudinal Study of Adolescent and Adult Health (Add Health) with a sample of 5,728 youth of European ancestry. The results showed that both ESA and PGSs were involved in different mechanisms. ESA contributed additively to educational failures, BMI, depressive symptoms, and diabetes risk over the life course (an additive process). Also, ESA launched a cascading process that connected these outcomes in a successively contingent manner. In addition to ESA, youths' multiple PGSs directly contributed to educational, psychological, and BMI outcomes. Multiple PGSs for education, BMI, and type 2 diabetes influenced not only youth outcomes that they were supposed to predict directly but also additional youth outcomes showing biological pleiotropy. The findings highlight the value of incorporating molecular genetic information into longitudinal developmental life course research and provide insight into malleable characteristics and appropriate timing for interventions addressing youth developmental and health outcomes.
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Affiliation(s)
| | - Thulitha Wickrama
- Department of Child, Youth and Family Studies, University of Nebraska
| | - Dayoung Bae
- Child and Adolescent Department, Korea University, Seoul, South Korea
| | - Michael Merten
- Department of Child, Youth and Family Studies, University of Nebraska
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13
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Wood AC, Arora A, Newell M, Bland VL, Zhou J, Pirastu N, Ordovas JM, Klimentidis YC. Identification of genetic loci simultaneously associated with multiple cardiometabolic traits. Nutr Metab Cardiovasc Dis 2022; 32:1027-1034. [PMID: 35168826 PMCID: PMC9275655 DOI: 10.1016/j.numecd.2022.01.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 12/09/2021] [Accepted: 01/04/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND AIMS Cardiometabolic disorders (CMD) arise from a constellation of features such as increased adiposity, hyperlipidemia, hypertension and compromised glucose control. Many genetic loci have shown associations with individual CMD-related traits, but no investigations have focused on simultaneously identifying loci showing associations across all domains. We therefore sought to identify loci associated with risk across seven continuous CMD-related traits. METHODS AND RESULTS We conducted separate genome-wide association studies (GWAS) for systolic and diastolic blood pressure (SBP/DBP), hemoglobin A1c (HbA1c), low- and high- density lipoprotein cholesterol (LDL-C/HDL-C), waist-to-hip-ratio (WHR), and triglycerides (TGs) in the UK Biobank (N = 356,574-456,823). Multiple loci reached genome-wide levels of significance (N = 145-333) for each trait, but only four loci (in/near VEGFA, GRB14-COBLL1, KLF14, and RGS19-OPRL1) were associated with risk across all seven traits (P < 5 × 10-8). We sought replication of these four loci in an independent set of seven trait-specific GWAS meta-analyses. GRB14-COBLL1 showed the most consistent replication, revealing nominally significant associations (P < 0.05) with all traits except DBP. CONCLUSIONS Our analyses suggest that very few loci are associated in the same direction of risk with traits representing the full spectrum of CMD features. We identified four such loci, and an understanding of the pathways between these loci and CMD risk may eventually identify factors that can be used to identify pathologic disturbances that represent broadly beneficial therapeutic targets.
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Affiliation(s)
- Alexis C Wood
- USDA/ARS Children's Nutrition Research Center, 1100 Bates Avenue, Houston, TX, USA.
| | - Amit Arora
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Michelle Newell
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Victoria L Bland
- Division of Geriatric Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Jin Zhou
- Department of Biostatistics, University of California, Los Angeles, CA, USA
| | - Nicola Pirastu
- Centre for Global Health Research, Usher Institute, University of Edinburgh, Edinburgh, Scotland, UK
| | - Jose M Ordovas
- Nutrition and Genomics Laboratory, Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA; IMDEA-Food, Madrid, Spain
| | - Yann C Klimentidis
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA; BIO5 Institute, University of Arizona, Tucson, AZ, USA
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14
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Ezzatvar Y, Izquierdo M, Ramírez-Vélez R, Del Pozo Cruz B, García-Hermoso A. Accuracy of different cutoffs of the waist-to-height ratio as a screening tool for cardiometabolic risk in children and adolescents: A systematic review and meta-analysis of diagnostic test accuracy studies. Obes Rev 2022; 23:e13375. [PMID: 34751482 DOI: 10.1111/obr.13375] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 09/24/2021] [Indexed: 12/11/2022]
Abstract
The present systematic review with meta-analysis sought to estimate the accuracy of different waist-to-height ratio (WHtR) cutoff ranges as risk indicators for cardiometabolic health in different populations of children and adolescents. Systematic searches were undertaken to identify studies in apparently healthy participants aged 3-18 years that conducted receiver operating characteristic curve analysis and reported area under the receiver operating characteristic curves for WHtR with any cardiometabolic biomarker. Forty-one cross-sectional studies were included in the meta-analysis, including 138,561 young individuals (50% girls). Higher area under summary receiver operating characteristic (AUSROC) values were observed in cutoffs between 0.46 and 0.50 (AUSROC = 0.83, 95%CI: 0.80-0.86) and ≥0.51 (AUSROC = 0.87, 95%CI: 0.84-0.90) (p < 0.001 in comparison with cutoffs 0.41 to 0.45), with similar results in both sexes. The AUSROC value increased in the East and Southeast Asian regions using a WHtR cutoff of ≥0.46 (AUSROC = 0.90, 95%CI: 0.87 to 0.92). A cutoff of ≥0.54 was optimal for the Latin American region (AUSROC = 0.96, 95%CI: 0.94-0.97). Our meta-analysis identified optimal cutoff values of WHtR for use in children and adolescents from different regions. Despite the widely accepted WHtR cutoff of 0.50, the present study indicated that a single cutoff value of WHtR may be inappropriate.
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Affiliation(s)
- Yasmin Ezzatvar
- Department of Nursing, Universitat de València, Valencia, Spain
| | - Mikel Izquierdo
- Navarrabiomed, Navarra Hospital Complex (CHN), Public University of Navarra (UPNA), Pamplona, Spain
| | - Robinson Ramírez-Vélez
- Navarrabiomed, Navarra Hospital Complex (CHN), Public University of Navarra (UPNA), Pamplona, Spain
| | - Borja Del Pozo Cruz
- Centre for Active and Healthy Ageing, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Antonio García-Hermoso
- Navarrabiomed, Navarra Hospital Complex (CHN), Public University of Navarra (UPNA), Pamplona, Spain.,Sciences of Physical Activity, Sports and Health School, University of Santiago of Chile (USACH), Santiago, Chile
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15
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Nishimi KM, Koenen KC, Coull BA, Kubzansky LD. Association of Psychological Resilience With Healthy Lifestyle and Body Weight in Young Adulthood. J Adolesc Health 2022; 70:258-266. [PMID: 34521575 PMCID: PMC8792157 DOI: 10.1016/j.jadohealth.2021.08.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 08/02/2021] [Accepted: 08/04/2021] [Indexed: 02/03/2023]
Abstract
PURPOSE Childhood adversity is associated with adverse health outcomes, in part owing to its effects on healthy lifestyle. We examined whether psychological resilience to adversity may promote healthier behaviors and body weight in young adulthood. METHODS Data are from the Growing Up Today Study, a longitudinal cohort of young adults (n = 3,767) who are children of participants of the Nurses' Health Study II, a separate longitudinal cohort. After characterizing psychological resilience as per levels of adversity exposure before the age of 18 years and young adult psychological health (defined by a composite of low psychological distress and high positive affect), we derived a categorical measure by cross-classifying adversity (exposed vs. unexposed) and psychological health (high vs. lower). We considered five outcomes self-reported at baseline (2010) and five years later: healthy body weight and four healthy lifestyle components including being a nonsmoker, moderate alcohol consumption, regular physical activity, and healthy diet. Poisson regression models evaluated associations of each outcome with psychological resilience, comparing psychologically resilient individuals with those who were not resilient or who were unexposed to adversity, adjusting for relevant covariates. RESULTS We did not identify differences between psychologically resilient individuals and those unexposed to adversity who were psychologically healthy with respect to meeting recommendations for most healthy lifestyle components and associations were largely stable over time. Across most outcomes, nonresilient individuals were less likely to be healthy relative to resilient individuals. CONCLUSIONS Psychological resilience may disrupt negative effects of childhood adversity on having a healthy lifestyle in young adulthood.
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Affiliation(s)
- Kristen M Nishimi
- Department of Psychiatry and Weill Institute for Neurosciences, University of California San Francisco, , San Francisco, California; Mental Health Service, San Francisco Veterans Affairs Medical Center, San Francisco, California.
| | - Karestan C Koenen
- Department of Social and Behavioral Science, Harvard TH Chan School of Public Health, Boston, Massachusetts; Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, Massachusetts
| | - Brent A Coull
- Department of Biostatistics, Harvard TH Chan School of Public Health, Boston, Massachusetts
| | - Laura D Kubzansky
- Department of Social and Behavioral Science, Harvard TH Chan School of Public Health, Boston, Massachusetts
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16
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Gentry AE, Robins J, Makowski M, Kliewer W. Differential DNA Methylation and Cardiometabolic Risk in African American Mother-Adolescent Dyads. Biol Res Nurs 2022; 24:75-84. [PMID: 34719281 PMCID: PMC9248288 DOI: 10.1177/10998004211039017] [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: 01/03/2023]
Abstract
BACKGROUND Cardiovascular disease disproportionately affects African Americans as the leading cause of morbidity and mortality. Among African Americans, compared to other racial groups, cardiovascular disease onset occurs at an earlier age due to a higher prevalence of cardiometabolic risk factors, particularly obesity, hypertension and type 2 diabetes. Emerging evidence suggests that heritable epigenetic processes are related to increased cardiovascular disease risk, but this is largely unexplored in adolescents or across generations. MATERIALS AND METHODS In a cross-sectional descriptive pilot study in low-income African American mother-adolescent dyads, we examined associations between DNA methylation and the cardiometabolic indicators of body mass index, waist circumference, and insulin resistance. RESULTS Four adjacent cytosine and guanine nucleotides (CpG) sites were significantly differentially methylated and associated with C-reactive protein (CRP), 62 with waist circumference, and none to insulin resistance in models for both mothers and adolescents. CONCLUSION Further study of the relations among psychological and environmental stressors, indicators of cardiovascular disease, risk, and epigenetic factors will improve understanding of cardiovascular disease risk so that preventive measures can be instituted earlier and more effectively. To our knowledge this work is the first to examine DNA methylation and cardiometabolic risk outcomes in mother-adolescent dyads.
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Affiliation(s)
- Amanda Elswick Gentry
- Department of Psychiatry, Virginia
Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University,
Richmond, VA, USA,Amanda Elswick Gentry, PhD, Department of
Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia
Commonwealth University, 800 East Leigh Street, Suite 100, Room 130-B, Richmond,
VA 23219, USA.
| | - Jo Robins
- School of Nursing, Virginia
Commonwealth University, Richmond, VA, USA
| | | | - Wendy Kliewer
- Department of Psychology, College of
Humanities and Sciences, Virginia Commonwealth University, Richmond, VA, USA
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17
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Matia-Garcia I, Vadillo E, Pelayo R, Muñoz-Valle JF, García-Chagollán M, Loaeza-Loaeza J, Vences-Velázquez A, Salgado-Goytia L, García-Arellano S, Parra-Rojas I. Th1/Th2 Balance in Young Subjects: Relationship with Cytokine Levels and Metabolic Profile. J Inflamm Res 2021; 14:6587-6600. [PMID: 34908860 PMCID: PMC8664383 DOI: 10.2147/jir.s342545] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Accepted: 11/22/2021] [Indexed: 12/22/2022] Open
Abstract
Purpose We aim to identify Th1 and Th2 cell clusters in young subjects, including their clinical and metabolic characteristics and the Th1/Th2 balance. Patients and Methods A total of 100 participants were included. The frequencies of Th1 and Th2 cells in peripheral blood were determined by flow cytometry. Serum C-reactive protein was measured using a turbidimetric assay, and insulin levels were quantified with an enzyme-linked immunosorbent assay. Circulating cytokine levels were analyzed using a multiplex system. Results A cluster analysis was performed to determine the Th1/Th2 balance in a group of young people, and 3 clusters were formed with the following characteristics: 1) subjects with a higher prevalence of hyperglycemia (38%), dyslipidemia (38–75%), and insulin resistance (50%), as well as a higher percentage of Th1 cells and Th1/Th2 ratio, including elevated IFN-ɣ levels; 2) subjects with a lower prevalence of hyperglycemia (23%) and insulin resistance (15.4%), but a higher prevalence of dyslipidemia (8–85%) with a predominance of Th2 cells, and lower Th1/Th2 ratio; 3) subjects with a lower prevalence of hyperglycemia (6%), insulin resistance (41%), and dyslipidemia (10–63%), as well as a balance of Th1 and Th2 cells and lower Th1/Th2 ratio, including low IFN-ɣ levels. Positive correlations between Th1 cells with IFN-γ, IL-12, and IL-1β and between Th2 cells with IFN-γ, IL-2, and IL-4 were found (p < 0.05). A significant increase in Th1 cells was observed in the presence of hyperglycemia and high LDL-C levels, as well as increased Th2 cells in the absence of abdominal obesity and high blood pressure, including low HDL-C levels. The Th1/Th2 ratio was higher in the group with high cardiometabolic risk (p = 0.03). Conclusion Th1/Th2 balance is related to metabolic abnormalities that may occur in young population, and thus the timely identification of different phenotypes may help predict an increased cardiometabolic risk.
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Affiliation(s)
- Ines Matia-Garcia
- Facultad de Ciencias Químico Biológicas, Universidad Autónoma de Guerrero, Chilpancingo, Guerrero, México
| | - Eduardo Vadillo
- Unidad de Investigación Médica en Enfermedades Oncológicas, Hospital de Oncología, Centro Médico Nacional, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | - Rosana Pelayo
- Centro de Investigación Biomédica de Oriente, Instituto Mexicano del Seguro Social, Atlixco, Puebla, México
| | - José F Muñoz-Valle
- Instituto de Investigación en Ciencias Biomédicas, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, México
| | - Mariel García-Chagollán
- Instituto de Investigación en Ciencias Biomédicas, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, México
| | - Jaqueline Loaeza-Loaeza
- Facultad de Ciencias Químico Biológicas, Universidad Autónoma de Guerrero, Chilpancingo, Guerrero, México
| | - Amalia Vences-Velázquez
- Facultad de Ciencias Químico Biológicas, Universidad Autónoma de Guerrero, Chilpancingo, Guerrero, México
| | - Lorenzo Salgado-Goytia
- Facultad de Ciencias Químico Biológicas, Universidad Autónoma de Guerrero, Chilpancingo, Guerrero, México
| | - Samuel García-Arellano
- Instituto de Investigación en Ciencias Biomédicas, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, México
| | - Isela Parra-Rojas
- Facultad de Ciencias Químico Biológicas, Universidad Autónoma de Guerrero, Chilpancingo, Guerrero, México
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18
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Mengarelli CA, Kirchoff C, Palacios C. College Students' Perception of Snacks Sold in Vending Machines in the US: A Mixed-Methods Study. Front Nutr 2021; 8:742121. [PMID: 34778337 PMCID: PMC8578334 DOI: 10.3389/fnut.2021.742121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 10/01/2021] [Indexed: 11/18/2022] Open
Abstract
Introduction: Food in vending machines in US colleges contain limited nutritious foods available for purchase, which could affect the food choices made by students leading to poor diet quality. Interventions to improve college foodscapes usually follow a top-down approach and fail to affect dietary behavioral changes ultimately. This research aims to uncover what students want and ways to achieve change. Methods: The mixed-methods approach included peer-led qualitative focus group discussions and a brief quantitative questionnaire on satisfaction from foods available in vending machines. A convenience sample of 20 students (15 females) was recruited from a Hispanic serving institution for this study. Results: Vending machines were perceived as convenient, plentiful, and unhealthy. Students expressed dissatisfaction with both the variety and nutritional quality of snacks in vending machines. Suggestions for improvement included more fresh items (fruits and vegetables) and refrigerated items with higher protein content (low-fat yogurt, hummus, and peanut butter). To implement these improvements, participants discussed the cost and feasibility of perishable items. Increasing awareness and partnering strategies were proposed to mediate potential cost and buy-in obstacles as was elevating the appeal of healthy vending machines with technological enhancements that draw customers in and educate. Conclusion and Implication for Practice: This group of college students was eager for positive changes in foods sold in vending machines and understand the major difficulties. The suggested changes may help this and other colleges develop policies to regulate the foods in vending machines to promote overall health and help prevent chronic diseases in the future.
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Affiliation(s)
- Cristiana Assumpção Mengarelli
- Department of Dietetics and Nutrition, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, United States
| | - Christie Kirchoff
- Department of Health Promotion & Disease Prevention, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, United States
| | - Cristina Palacios
- Department of Dietetics and Nutrition, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, United States
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19
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How Early Stressful Life Experiences Combine With Adolescents' Conjoint Health Risk Trajectories to Influence Cardiometabolic Disease Risk in Young Adulthood. J Youth Adolesc 2021; 50:1234-1253. [PMID: 33948830 DOI: 10.1007/s10964-021-01440-0] [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: 02/13/2021] [Accepted: 04/14/2021] [Indexed: 10/21/2022]
Abstract
Research has primarily focused on additive (unique) associations between early stressful life experiences (specifically, socioeconomic adversity and maltreatment) and young adults' cardiometabolic disease risk without considering multiplicative (synergistic) influences. Furthermore, research has not fully considered the varying patterns of health risk trajectories (e.g., substance use, obesogenic-related behaviors, depressive symptoms) across adolescence and the transition to young adulthood that may link earlier stressful experiences and later cardiometabolic disease risk. This study examined heterogeneity in conjoint health risk trajectories from adolescence to the transition to young adulthood and their additive and multiplicative (synergistic) influences with early stressful life experiences on cardiometabolic disease risk in young adulthood using data from the National Longitudinal Study of Adolescent to Adult Health (n = 9,421; 55.6% female) over a period of 13 years. Four distinct conjoint health risk trajectories were identified considering trajectories of substance use behaviors, obesogenic-related behaviors, and depressive symptoms: (a) overall high-risk, (b) behavioral risks, (c) psycho-obesogenic risks, and (d) overall low-risk. Socioeconomic adversity and maltreatment were additively and multiplicatively associated with cardiometabolic disease risk in young adulthood. Individuals with overall high-risk conjoint trajectories averaged higher cardiometabolic disease risk in young adulthood when they were exposed to early socioeconomic adversity. Implications for personalized interventions for individuals who have experienced multiple forms of health risks are discussed.
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20
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Setiono FJ, Guerra LA, Leung C, Leak TM. Sociodemographic characteristics are associated with prevalence of high-risk waist circumference and high-risk waist-to-height ratio in U.S. adolescents. BMC Pediatr 2021; 21:215. [PMID: 33941130 PMCID: PMC8091763 DOI: 10.1186/s12887-021-02685-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 04/16/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Adiposity status in adolescence is associated with various health outcomes in adulthood. Waist circumference [WC] and waist-to-height ratio [WHtR] are measures of abdominal obesity and have shown to be valid predictors of future chronic diseases. However, the relationship between sociodemographic characteristics and WC, as well as WHtR in U.S. adolescents remain unclear. Thus, the study aims to examine associations between sociodemographic characteristics and abdominal obesity among a nationally representative sample of U.S. adolescents. METHODS The sample included 4712 adolescents (12-19 years) in the 2007-2016 National Health and Nutrition Examination Survey. Associations between sociodemographic characteristics and abdominal obesity (WC and WHtR) were examined using multiple logistic regression models, adjusted for age, physical activity level, and sedentary activity. RESULTS Around 18% of adolescents had high-risk WC (≥90th percentile) and 34% had high-risk WHtR (≥0.5). Females had higher odds of high-risk WHtR compared to males (OR = 1.46, 95%CI = 1.23-1.72). Mexican American adolescents had higher odds of high-risk WHtR compared to non-Hispanic White (OR = 1.66, 95%CI = 1.24-2.20), non-Hispanic Black (OR = 1.73, 95%CI = 1.26-2.36), and other race/multi-racial adolescents (OR = 1.84, 95%CI = 1.21-2.80). When their parent were college graduates, adolescents had lower odds for high-risk WC compared to when the parent had some college education (OR = 0.68, 95%CI = 0.49-0.93) or a high school degree or less (OR = 0.70, 95%CI = 0.51-0.97). Similar associations were seen between parental education level and high-risk WHtR, as well as between household income and high-risk WHtR. CONCLUSIONS Measures of abdominal obesity should be considered to assess burden of adiposity, especially among female adolescents, adolescents from racial/ethnic minority and low socioeconomic status backgrounds. Additionally, future health interventions should consider including changes in WC and WHtR to measure the impact of these interventions.
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Affiliation(s)
- Felicia J Setiono
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, 14853, USA.
| | - Laura A Guerra
- Department of Health & Behavior Studies, Teachers College, Columbia University, New York, NY, USA
| | - Cindy Leung
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Tashara M Leak
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, 14853, USA
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21
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Nunes HEG, Faria EA, Martinez PF, Oliveira-Júnior SAD. Cardiovascular health indicators in soccer exercise during adolescence: systematic review. Int J Adolesc Med Health 2021; 33:53-63. [PMID: 33823092 DOI: 10.1515/ijamh-2020-0301] [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: 12/16/2020] [Accepted: 03/07/2021] [Indexed: 11/15/2022]
Abstract
This review analyzed the studies that evaluated cardiovascular health indicators (blood pressure, waist circumference, heart rate, glucose index and lipid blood) in recreational soccer players during adolescence, and identify possible associated factors. The search was performed in the electronic databases (PubMED, SciELO, LILACS, Scopus, SPORTDiscus and Web of Science). Inclusion criteria were: population composed of children and/or adolescents (10-19 years or average age up to 19 years); studies adolescents engaged in recreational soccer regularly and observational studies with cross-sectional or longitudinal design. The process of analysis of studies involved reading titles, abstracts and full texts. After these phases, seven articles were eligible. Regarding the design, all studies were cross-sectional. Of the total studies included, five presented moderate methodological quality values and two presented low methodological quality values, according to National Heart, Lung, and Blood Institute instrument. The most cardiovascular health indicators used in recreational soccer players during adolescence was waist circumference; three studies analyzed heart rate, two evaluated blood pressure, one analyzed insulin resistance and none of the included studies analyzed lipid profile. Factors associated were analyzed in four studies, being that sedentary time and body mass index (BMI) present association with at least one indicator of cardiovascular health.
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Affiliation(s)
- Heloyse Elaine Gimenes Nunes
- Laboratory of Striated Muscle Study (LEME/INISA), Federal University of Mato Grosso do Sul (UFMS), Campo Grande, MS, Brazil
| | - Evelinn Amarilha Faria
- Laboratory of Striated Muscle Study (LEME/INISA), Federal University of Mato Grosso do Sul (UFMS), Campo Grande, MS, Brazil
| | - Paula Felippe Martinez
- Laboratory of Striated Muscle Study (LEME/INISA), Federal University of Mato Grosso do Sul (UFMS), Campo Grande, MS, Brazil
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22
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Patterns of Avoiding Nutrition Mistakes in Metropolitan Adolescents Are Associated with Sex, Nutrition Knowledge, Physical Activity, and Family Environment. Nutrients 2021; 13:nu13020433. [PMID: 33572706 PMCID: PMC7911558 DOI: 10.3390/nu13020433] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 01/20/2021] [Accepted: 01/26/2021] [Indexed: 11/19/2022] Open
Abstract
A comprehensive approach to the identification of the relationship between behaviors limiting nutrition mistakes, nutrition knowledge, and physical activity in the context of the family environment has not yet been widely explored. We aim to identify patterns of avoiding nutrition mistakes in high school students from Warsaw, Poland, and to assess their associations with nutrition knowledge (NK), physical activity (PA), body mass index (BMI), demographic, and family environment characteristics. A cross-sectional study involving 616 high school students, aged 16–19, was conducted. The data were collected by distributing questionnaires. The k-means method was used for cluster analysis, and logistic regression was used to assess the adherence to identified patterns. We identified three patterns: Prudent Ones (45%), Inconsequent (39%), and Rebels (16%). About 70% of adolescents had insufficient NK. The adherence to the Rebels pattern was lower by 85 % in girls, by 68% in students with younger siblings, and was about 4.0-times higher in children of mothers with primary education, 2.4 times higher in students with insufficient NK, and 1.9-times higher in students living in a family with more than 4 persons. The groups of adolescents with feature characteristics of the Rebels and Inconsequent are possible targets for intervention and require further in-depth research to explain their lack of attempts to avoid nutrition mistakes. The results clearly indicate the necessity of including metropolitan teenage boys in effective nutritional education for the rationalization of their dietary behavior.
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23
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Ramos-Arellano LE, Matia-Garcia I, Marino-Ortega LA, Castro-Alarcón N, Muñoz-Valle JF, Salgado-Goytia L, Salgado-Bernabé AB, Parra-Rojas I. Obesity, dyslipidemia, and high blood pressure are associated with cardiovascular risk, determined using high-sensitivity C-reactive protein concentration, in young adults. J Int Med Res 2020; 48:300060520980596. [PMID: 33342336 PMCID: PMC7756045 DOI: 10.1177/0300060520980596] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective Few studies have investigated the relationships between high-sensitivity C-reactive protein (hs-CRP) concentration and conventional cardiometabolic markers in young adults. The aim of this study was to characterize the cardiometabolic profile of young adults who are at high cardiovascular risk, according to hs-CRP concentration. Methods A cross-sectional study was conducted in 300 young adults (18 to 30 years old) from southern Mexico (n = 150 normal-weight and n = 150 obese). Their circulating lipid and glucose concentrations were measured using colorimetric enzymatic assays, and their hs-CRP, ApoA, and ApoB concentrations were measured using turbidimetric assays. Results The most prevalent abnormalities in the participants with high cardiovascular risk, determined using an hs-CRP >28.57 nmol/L, were high waist circumference (85.7%), obesity (83.9%), high low-density lipoprotein-cholesterol (64.3%), low high-density lipoprotein-cholesterol (50%), Apo B in the highest tertile (39.3%), hypertriglyceridemia (35.7%), and high blood pressure (30.4%). In addition, there were strong associations between hs-CRP >28.57 nmol/L and obesity (odds ratio [OR] = 13.9), high waist circumference (OR = 8.0), hypertriglyceridemia (OR = 4.0), high blood pressure (OR = 3.4), hypercholesterolemia (OR = 2.8), and Apo B in the highest tertile (OR = 2.4). Conclusion The principal cardiometabolic alterations associated with high cardiovascular risk, determined using hs-CRP, are obesity, dyslipidemia, and high blood pressure in young adults.
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Affiliation(s)
- Luz Elena Ramos-Arellano
- Facultad de Ciencias Químico Biológicas, Universidad Autónoma de Guerrero, Chilpancingo, Guerrero, México
| | - Ines Matia-Garcia
- Facultad de Ciencias Químico Biológicas, Universidad Autónoma de Guerrero, Chilpancingo, Guerrero, México
| | - Linda Anahi Marino-Ortega
- Facultad de Ciencias Químico Biológicas, Universidad Autónoma de Guerrero, Chilpancingo, Guerrero, México
| | - Natividad Castro-Alarcón
- Facultad de Ciencias Químico Biológicas, Universidad Autónoma de Guerrero, Chilpancingo, Guerrero, México
| | - José Francisco Muñoz-Valle
- Instituto de Investigación en Ciencias Biomédicas, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, México
| | - Lorenzo Salgado-Goytia
- Facultad de Ciencias Químico Biológicas, Universidad Autónoma de Guerrero, Chilpancingo, Guerrero, México
| | | | - Isela Parra-Rojas
- Facultad de Ciencias Químico Biológicas, Universidad Autónoma de Guerrero, Chilpancingo, Guerrero, México
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Merianos AL, Jacobs W, Oloruntoba O, Gittens OE, Smith ML. Perceived Severity of Interrelated Cardiometabolic Risk Factors among U.S. College Students. AMERICAN JOURNAL OF HEALTH EDUCATION 2020; 51:234-243. [DOI: 10.1080/19325037.2020.1765907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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25
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Berg MT, Lei MK, Beach SR, Simons RL, Simons LG. Childhood Adversities as Determinants of Cardiovascular Disease Risk and Perceived Illness Burden in Adulthood: Comparing Retrospective and Prospective Self-Report Measures in a Longitudinal Sample of African Americans. J Youth Adolesc 2020; 49:1292-1308. [PMID: 32080780 PMCID: PMC7981841 DOI: 10.1007/s10964-020-01207-z] [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] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 02/01/2020] [Indexed: 01/13/2023]
Abstract
A large body of evidence suggests that exposure to childhood adversities increases risk for poor quality physical health in adulthood. Much of this evidence is based on retrospective measures which are believed to be contaminated by the limitations and biases of autobiographical memory. Using longitudinal data on 454 African Americans (61 percent female) this study examines the corroboration between prospective and retrospective measures of childhood adversities gathered approximately two decades apart, and the relative ability of the measures to predict self-reported illnesses and a biomarker of 30-year cardiovascular disease risk. Comparisons indicated that the retrospective and prospective measures demonstrated weak convergence and did not provide completely equivalent information about self-reported adverse childhood experiences. A series of regression models indicated that the two measures of adversities exhibited similar associations with the cardiovascular disease biomarker but divergent associations with self-reported illnesses. Furthermore, both the prospective and retrospective measures simultaneously predicted cardiovascular disease risk in adulthood. That the prospective measure did not significantly predict perceived illnesses after adjusting for the retrospective measure is evidence that childhood adversities predict self-reported health burden insofar as respondents remember those adversities as adults. The findings provide evidence that retrospective self-report measures of childhood adversities do not closely converge with prospective measures, and that retrospective measures may not provide valid estimates of the association between childhood adversities and perceived illnesses in adulthood.
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Affiliation(s)
- Mark T Berg
- Department of Sociology and Criminology, University of Iowa, Iowa City, IA, 52242, USA.
| | - Man-Kit Lei
- Department of Sociology, University of Georgia, Athens, GA, USA
| | - Steven R Beach
- Department of Psychology, University of Georgia, Athens, GA, USA
| | - Ronald L Simons
- Department of Sociology, University of Georgia, Athens, GA, USA
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26
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Correa-Rodríguez M, González-Ruíz K, Rincón-Pabón D, Izquierdo M, García-Hermoso A, Agostinis-Sobrinho C, Sánchez-Capacho N, Roa-Cubaque MA, Ramírez-Vélez R. Normal-Weight Obesity Is Associated with Increased Cardiometabolic Risk in Young Adults. Nutrients 2020; 12:nu12041106. [PMID: 32316150 PMCID: PMC7230158 DOI: 10.3390/nu12041106] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 04/03/2020] [Accepted: 04/03/2020] [Indexed: 12/11/2022] Open
Abstract
Normal-weight obesity (NWO) has been shown to be associated with cardiometabolic dysfunction. However, little is known regarding this potential relationship in early adulthood. The aim of this study was to investigate the associations between NWO and cardiometabolic risk factors in a large population of Colombian young adults. A cross-sectional study was conducted on 1354 subjects (61% women), aged from 18 to 30. Anthropometric data, including body mass index (BMI) and waist circumference (WC), were estimated, and the percentage of fat mass was measured through bioelectrical impedance analysis (BIA). Muscular fitness was determined by using a handgrip strength test and normalized grip strength (NGS = handgrip (kg)/body mass (kg)). A cardiometabolic risk Z-score was derived by assessing WC, triglycerides, high-density lipoprotein cholesterol (HDL-C) cholesterol, fasting glucose, and systolic blood pressure. NWO was defined by the combination of excess %BF (over 25.5% for men and 38.9% for women) and a BMI < 25 kg/m2. The overall prevalence of NWO was 29.1%. Subjects with NWO have an increased risk of cardiometabolic risk compared to the normal-weight lean group (OR = 3.10). Moreover, NWO was associated with an increased risk of presenting low HDL-C (OR = 2.34), high abdominal obesity (OR = 7.27), and low NGS (OR = 3.30), p < 0.001. There is a high prevalence of NWO in American Latin young adults and this condition is associated with an increased cardiovascular risk, high blood pressure, low HDL-C, high abdominal obesity, and low muscular strength early in life. Screening for adiposity in subjects with a normal BMI could help to identify young adults at a high risk of cardiometabolic abnormalities.
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Affiliation(s)
- María Correa-Rodríguez
- Faculty of Health, Department of Nursing, University of Granada, Av. Ilustración, 60, 18016 Granada, Spain;
| | - Katherine González-Ruíz
- Grupo de Ejercicio Físico y Deportes, Vicerrectoría de Investigaciones, Universidad Manuela Beltrán, Bogotá DC 110231, Colombia;
| | - David Rincón-Pabón
- ZIPATEFI (Zona de Investigaciones de Posgrados, Terapia Respiratoria y Fisioterapia de Areandina), Fundación Universitaria del Área Andina, Pereira 110231, Colombia;
| | - Mikel Izquierdo
- Department of Health Sciences, Public University of Navarra, Navarrabiomed- IdiSNA, Complejo Hospitalario de Navarra (CHN), 31008 Pamplona, Spain; (M.I.); (A.G.-H.)
- CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Antonio García-Hermoso
- Department of Health Sciences, Public University of Navarra, Navarrabiomed- IdiSNA, Complejo Hospitalario de Navarra (CHN), 31008 Pamplona, Spain; (M.I.); (A.G.-H.)
- Laboratorio de Ciencias de la Actividad Física, el Deporte y la Salud, Facultad de Ciencias Médicas, Universidad de Santiago de Chile, USACH, Santiago 7500618, Chile
| | | | - Nohora Sánchez-Capacho
- Facultad de Ciencias de la Salud- Universidad de Boyacá, Tunja 150003, Colombia; (N.S.-C.); (M.A.R.-C.)
| | | | - Robinson Ramírez-Vélez
- Department of Health Sciences, Public University of Navarra, Navarrabiomed- IdiSNA, Complejo Hospitalario de Navarra (CHN), 31008 Pamplona, Spain; (M.I.); (A.G.-H.)
- CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Correspondence: ; Tel.: +34-695-526-321
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27
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Pool AC, Coffman DL, Sarwer DB, LaRose JG, Hart CN. Associations between weight misperception, contextual factors, and weight loss behaviours in young adult men with overweight/obesity. Obes Sci Pract 2020; 6:39-46. [PMID: 32128241 PMCID: PMC7042023 DOI: 10.1002/osp4.382] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 10/14/2019] [Accepted: 10/16/2019] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Young men are less likely to engage in weight loss behaviours than their female counterparts. This may be because of an increased likelihood for young men, particularly young black men, with overweight/obesity to misperceive their weight status. This study examined racial differences in weight status perception accuracy and associations between this perception and weight loss behaviours among young men. Associations between weight loss behaviours and contextual factors were also explored. METHODS Data from 1417 young adult (YA) men with overweight/obesity from the 2007 to 2014 National Health and Nutrition Examination Survey (NHANES) were analysed. Associations between weight status perception accuracy, contextual factors, and weight loss attempts and behaviours were examined with logistic regression. RESULTS YA men with overweight/obesity were more likely to report weight loss attempts and behaviours if they perceived themselves as being overweight (OR = 3.10; 95% CI, 2.18-4.41; P < .01; OR = 3.20, 95% CI, 2.16-4.72, P < .01, respectively). Greater education and income were associated with a greater likelihood of reporting weight loss attempts and healthy weight loss behaviours. Greater reported depressive symptoms were associated with reported weight loss attempts but not healthy weight loss behaviours. There were no differences by race for reported weight loss attempts or behaviours. CONCLUSION Among YA men with overweight/obesity, perceiving oneself as overweight was associated with reporting weight loss attempts and healthy weight loss behaviours. Future research should consider how weight status perception accuracy affects weight loss attempts among YA men and what additional factors may account for racial differences.
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Affiliation(s)
- Andrew C. Pool
- Center for Parent and Teen CommunicationCraig‐Dalsimer Division of Adolescent Medicine, Children's Hospital of PhiladelphiaPhiladelphiaPennsylvania
| | - Donna L. Coffman
- Department of Epidemiology and BiostatisticsTemple UniversityPhiladelphiaPennsylvania
| | - David B. Sarwer
- Center for Obesity Research and EducationTemple UniversityPhiladelphiaPennsylvania
- Department of Social and Behavioral SciencesTemple UniversityPhiladelphiaPennsylvania
| | - Jessica G. LaRose
- Department of Health Behavior and PolicyVirginia Commonwealth University School of MedicineRichmondVirginia
| | - Chantelle N. Hart
- Center for Obesity Research and EducationTemple UniversityPhiladelphiaPennsylvania
- Department of Social and Behavioral SciencesTemple UniversityPhiladelphiaPennsylvania
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28
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Bihuniak JD, Bryant T, Kleiman J, Rotondo M, Decoteau J, Haisley S, Monserrate D, Cunningham M, MacKenzie A, Dauz S, Ippolito R, Fernandes N, LaRose JG, Leahey TM. Behavioural weight loss treatment preferences of college students with overweight and obesity. Clin Obes 2020; 10:e12343. [PMID: 31613059 DOI: 10.1111/cob.12343] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 09/04/2019] [Accepted: 09/11/2019] [Indexed: 01/08/2023]
Abstract
The college environment increases risk of weight gain in young adults with overweight/obesity. Behavioural weight loss interventions are proven effective, however, young adults' adherence to such programs is poor. The purpose of the study was to determine weight loss treatment preferences of 2- and 4-year college students for the development of population-specific interventions. Students with a BMI ≥25, between 18 and 24 years of age, and enrolled in one of four institutions were recruited. A questionnaire was developed to assess students' preferences and was administered via Qualtrics. BMI was calculated from objectively assessed height and weight measurements. Descriptive analyses, chi-square, Fisher's Exact Test, Mann-Whitney U test and Cramer's V were performed. Participants (n = 133, age = 20.2 ± 1.8) predominately identified as female (70%), non-Hispanic (68%) and Black/African American (32%) or White (32%). Fifty-five percent met criteria for obesity. Most students preferred session length of ≤1 hour (78%), for meetings to be held on a weekday (70%) and for both a peer and a professional to co-facilitate meetings (61%). Preferences for health outcomes and physical activity monitoring, type of physical activity, frequency of dietary monitoring, physical activity tracking method and interest in financial incentives to promote core treatment components differed between institutions. Heterogeneity in program preferences by college environment should be considered when designing weight loss interventions.
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Affiliation(s)
- Jessica D Bihuniak
- Department of Nutrition and Food Studies, Steinhardt School of Culture, Education, and Human Development, New York University, New York, New York
| | - Tiffany Bryant
- Department of Nutrition and Food Studies, Steinhardt School of Culture, Education, and Human Development, New York University, New York, New York
| | - Jennifer Kleiman
- Department of Nutrition and Food Studies, Steinhardt School of Culture, Education, and Human Development, New York University, New York, New York
| | - Megan Rotondo
- Department of Allied Health Sciences, University of Connecticut, Storrs, Connecticut
| | - Jessica Decoteau
- Department of Allied Health Sciences, University of Connecticut, Storrs, Connecticut
| | - Samantha Haisley
- Department of Nutrition and Food Studies, Steinhardt School of Culture, Education, and Human Development, New York University, New York, New York
- Health Sciences Department, LaGuardia Community College, Long Island City, New York
| | - David Monserrate
- Health and Exercise Science Program, Manchester Community College, Manchester, Connecticut
| | - Michael Cunningham
- Health and Exercise Science Program, Manchester Community College, Manchester, Connecticut
| | - Allison MacKenzie
- Health and Exercise Science Program, Manchester Community College, Manchester, Connecticut
| | - Steve Dauz
- Health Sciences Department, LaGuardia Community College, Long Island City, New York
| | - Rosann Ippolito
- Health Sciences Department, LaGuardia Community College, Long Island City, New York
| | - Nicolle Fernandes
- Health Sciences Department, LaGuardia Community College, Long Island City, New York
| | - Jessica G LaRose
- Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond, Virginia
| | - Tricia M Leahey
- Department of Allied Health Sciences, University of Connecticut, Storrs, Connecticut
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Saydah SH, Siegel KR, Imperatore G, Mercado C, Gregg EW. The Cardiometabolic Risk Profile of Young Adults With Diabetes in the U.S. Diabetes Care 2019; 42:1895-1902. [PMID: 31221678 DOI: 10.2337/dc19-0707] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 06/05/2019] [Indexed: 02/03/2023]
Abstract
OBJECTIVE We examined young adults with and young adults without diabetes by using demographic data and cardiometabolic risk profiles and compared the risk profiles of younger versus older (aged ≥45 years) adults with diabetes. RESEARCH DESIGN AND METHODS Data were obtained from the National Health and Nutrition Examination Survey (NHANES) 2007-2016. Diabetes was defined by self-report of health care provider diagnosis or by A1C levels of 6.5% or higher among those without a self-reported diagnosis. The cardiometabolic risk profile included adiposity, blood pressure, serum lipids, healthy eating, physical activity (PA), and exposure to tobacco smoke. Adjusted difference in difference was calculated as the difference among younger adults with and younger adults without diabetes minus the difference among older adults with and older adults without diabetes. RESULTS Adults with diabetes in both age-groups had higher levels of adiposity, hypertension, and cholesterol and lower levels of healthy eating and leisure-time PA. However, the differences in high cholesterol and adiposity by diabetes status were greater among young adults compared with older adults after adjustment for demographics and health insurance status. Elevated lipids were 9.6 percentage points higher (95% CI 4.6, 14.5) and obesity was 37.3 percentage points higher (95% CI 31.8, 42.7) among young adults with diabetes compared with those without diabetes than among older adults with diabetes compared with those without diabetes. CONCLUSIONS Young adults with diabetes have high rates of cardiometabolic risk factors, which can lead to an increased disease prevalence and mortality rate among these individuals as they age.
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Affiliation(s)
- Sharon H Saydah
- Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
| | - Karen R Siegel
- Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
| | - Giuseppina Imperatore
- Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
| | - Carla Mercado
- Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
| | - Edward W Gregg
- Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
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Jikamo B, Samuel M. Does dietary diversity predict the nutritional status of adolescents in Jimma Zone, Southwest Ethiopia? BMC Res Notes 2019; 12:402. [PMID: 31307544 PMCID: PMC6628467 DOI: 10.1186/s13104-019-4437-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 07/05/2019] [Indexed: 01/22/2023] Open
Abstract
Objective This study aimed to assess the association between dietary diversity and nutritional status of adolescents in Jimma Zone, Southwest Ethiopia. A secondary data was used to assess the association between dietary diversity and nutritional status of adolescents in Jimma Zone, Southwest Ethiopia. Adolescents in the age of 13–17 years old included in the analysis. The data cleaned, coded and analyzed using Stata version 14. Results Over all prevalence of stunting and thinness were 26.1% and 25.3%. Stunting was higher among female adolescents (23.8%) than male (21.9%), while thinness was higher among male (27.5%) than female (25.3%) adolescents. In multivariate binary logistic regression model, being female adolescents were 98% (AOR = 1.98; 95% CI 1.6, 2.4] higher odd of stunted compared with those male adolescents, households had food insecurity were 67% [AOR = 1.67; 95% CI 0.6, 0.9] more likely to be associated with stunted than with those households which had secure foods. Adolescents who had high workload were 2.6 times [AOR = 2.6; 95% CI 1.2, 3.1] more likely to be associated with thinness compared with those adolescents who didn’t had high workload.
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Affiliation(s)
- Birhanu Jikamo
- College of Medicine and Health Sciences, School of Public Health, Hawassa University, Hawassa, Ethiopia.
| | - Mekonen Samuel
- Hossaena Town Communicable Disease Control Clinical Officer, Hosanna, Ethiopia
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Lago-Ballesteros J, Martins J, González-Valeiro MÁ, Fernández-Villarino MA. Parental assessment of physical education in the school curriculum: A brief report on the influence of past experiences as students. PLoS One 2019; 14:e0219544. [PMID: 31291369 PMCID: PMC6619797 DOI: 10.1371/journal.pone.0219544] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 06/26/2019] [Indexed: 01/01/2023] Open
Abstract
The aim of this study was to analyse the relationship between parents' past experience as Physical Education (PE) students and the importance they give to PE within the school curriculum. Parents of 1834 teenagers from Spain and Portugal participated in the study (1834 fathers and 1834 mothers). An 11 item questionnaire was used for data collection. The measures studied were: socio-demographic characteristics, parent´s past experience as PE students, and importance that parents gave to PE in the school curriculum. The results suggest that parents' past experiences as PE student condition their evaluation of the importance that PE should have in the school curriculum. As the past experience as PE student deteriorated and as age increased, there was an increase in the probability that parents evaluate PE as deserving a less important status in their children's curriculum. These findings can contribute to understanding how the parents' past experiences as PE students seem to partially model the value judgements that they make later in life regarding the importance of the subject.
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Affiliation(s)
| | - João Martins
- Pedagogy Laboratory, Faculty of Human Kinetics and Unit for Research and Development in Education and Training, Institute of Education, University of Lisbon, Lisbon, Portugal
- Faculty of Physical Education and Sport, Universidade Lusófona, Lisbon, Portugal
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Chung ST, Onuzuruike AU, Magge SN. Cardiometabolic risk in obese children. Ann N Y Acad Sci 2019; 1411:166-183. [PMID: 29377201 DOI: 10.1111/nyas.13602] [Citation(s) in RCA: 99] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Revised: 12/29/2017] [Accepted: 12/31/2017] [Indexed: 02/06/2023]
Abstract
Obesity in childhood remains a significant and prevalent public health concern. Excess adiposity in youth is a marker of increased cardiometabolic risk (CMR) in adolescents and adults. Several longitudinal studies confirm the strong association of pediatric obesity with the persistence of adult obesity and the future development of cardiovascular disease, diabetes, and increased risk of death. The economic and social impact of childhood obesity is further exacerbated by the early onset of the chronic disease burden in young adults during their peak productivity years. Furthermore, rising prevalence rates of severe obesity in youth from disadvantaged and/or minority backgrounds have prompted the creation of additional classification schemes for severe obesity to improve CMR stratification. Current guidelines focus on primary obesity prevention efforts, as well as screening for clustering of multiple CMR factors to target interventions. This review summarizes the scope of the pediatric obesity epidemic, the new severe obesity classification scheme, and examines the association of excess adiposity with cardiovascular and metabolic risk. We will also discuss potential questions for future investigation.
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Affiliation(s)
- Stephanie T Chung
- Section on Ethnicity and Health, National Institute of Diabetes, Digestive and Kidney Diseases, NIH, Bethesda, Maryland.,Division of Pediatric Endocrinology and Diabetes, Children's National Health System, George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Anthony U Onuzuruike
- Section on Ethnicity and Health, National Institute of Diabetes, Digestive and Kidney Diseases, NIH, Bethesda, Maryland
| | - Sheela N Magge
- Division of Pediatric Endocrinology and Diabetes, Children's National Health System, George Washington University School of Medicine and Health Sciences, Washington, DC
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Krist AH. The Significance (or Insignificance) of Lower Lipids in Adolescents Who Were Exclusively Breastfed. Pediatrics 2019; 143:peds.2019-0447. [PMID: 30967485 DOI: 10.1542/peds.2019-0447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/19/2019] [Indexed: 11/24/2022] Open
Affiliation(s)
- Alex H Krist
- Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, Virginia
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Salim TR, Soares GP, Klein CH, Oliveira GMM. Fetal and maternal factors are associated with mortality due to circulatory system disorders in children. Rev Saude Publica 2019; 53:31. [PMID: 30942273 PMCID: PMC6474750 DOI: 10.11606/s1518-8787.2019053000793] [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: 03/05/2018] [Accepted: 05/09/2018] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To analyze the association of characteristics recorded at the time of birth, including weight, occurrence of asphyxia, gestation duration, maternal age and education level, with death from diseases or malformations of the circulatory system in children under 18 years of age. METHODS The Brazilian Information System on Live Births and Information System on Mortality databases were linked and evaluated following a longitudinal cohort analysis strategy. The following independent variables were evaluated: characteristics recorded at the time of birth, including weight, occurrence of asphyxia, gestation duration, maternal age and education level. Dependent variables were death from diseases or malformations of the circulatory system in children under 18 years of age. Crude relative risks were estimated and relative risks were adjusted for the variables. RESULTS 6,380 deaths were linked to 4,282,260 birth records, yielding 5,062 pairs considered as true. Low birth weight (RR = 2.26), asphyxia at 1 (RR = 1.72) and 5 minutes (RR = 1.51), prematurity (RR = 1.50), maternal age ≥ 40 years (RR = 2.06), and low maternal education level (RR = 1.45) increased the probability of death caused by circulatory system diseases. In the association with death by malformations of the circulatory system, the predictive variables showed the same association profile, but with greater intensity. CONCLUSIONS Fetal and maternal factors are associated with increased mortality due to diseases and malformations of the circulatory system. Measures to control these factors and improve access to their diagnosis and treatment would contribute to reducing the number of deaths caused by diseases and malformations of the circulatory system. However, the identification of environmental influences during gestation and birth on the risk of death should be carefully considered due to being influenced by genetic factors.
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Affiliation(s)
- Thais Rocha Salim
- Universidade Federal do Rio de Janeiro. Faculdade de Medicina. Instituto do Coração Edson Saad. Rio de Janeiro, RJ, Brasil.,Universidade de Vassouras. Curso de Medicina. Vassouras, RJ, Brasil
| | - Gabriel Porto Soares
- Universidade Federal do Rio de Janeiro. Faculdade de Medicina. Instituto do Coração Edson Saad. Rio de Janeiro, RJ, Brasil.,Universidade de Vassouras. Curso de Medicina. Vassouras, RJ, Brasil
| | - Carlos Henrique Klein
- Universidade Federal do Rio de Janeiro. Faculdade de Medicina. Instituto do Coração Edson Saad. Rio de Janeiro, RJ, Brasil.,Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública. Rio de Janeiro, RJ, Brasil
| | - Gláucia Maria Moraes Oliveira
- Universidade Federal do Rio de Janeiro. Faculdade de Medicina. Instituto do Coração Edson Saad. Rio de Janeiro, RJ, Brasil
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Cheung PC, Franks PA, Kramer MR, Kay CM, Drews-Botsch CD, Welsh JA, Gazmararian JA. Elementary school physical activity opportunities and physical fitness of students: A statewide cross-sectional study of schools. PLoS One 2019; 14:e0210444. [PMID: 30645628 PMCID: PMC6333378 DOI: 10.1371/journal.pone.0210444] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2018] [Accepted: 12/21/2018] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Using a cross-sectional design, we assessed the relationship between the time schools provide for physical activity and the proportion of students achieving a healthy aerobic capacity or body mass index. METHODS In 2013-2014, physical education and grade-level teachers from 905 of 1,244 Georgia elementary schools provided survey data about the frequency and duration of physical activity opportunities offered before, during, and after school. Log-binomial models related the weekly physical activity minutes provided by schools to the proportion of children in the FitnessGram healthy fitness zone for aerobic capacity or body mass index while adjusting for school characteristics and demographics. RESULTS During-school physical activity time was not associated with student fitness, but schools with before-school physical activity programs had a moderately higher prevalence of healthy aerobic capacity (prevalence ratio among girls: 1.06; 99% confidence interval: 1.00-1.13; prevalence ratio among boys: 1.03; 99% confidence interval: 0.99-1.08). Each additional 30 minutes of recess per week was associated with no more than a 3%-higher proportion of students with healthy body mass indexes (prevalence ratio among girls: 1.01; 99% confidence interval: 1.00-1.03; prevalence ratio among boys: 1.01; 99% confidence interval: 0.99-1.03). CONCLUSIONS The amount of physical activity time provided by schools is not strongly associated with school-aggregated student fitness. Future studies should be designed to assess the importance of school-based physical activity time on student fitness, relative to physical activity type and quality.
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Affiliation(s)
- Patricia C. Cheung
- Department of Epidemiology, Emory University, Atlanta, Georgia, United States of America
| | | | - Michael R. Kramer
- Department of Epidemiology, Emory University, Atlanta, Georgia, United States of America
| | - Christi M. Kay
- HealthMPowers, Norcross, Georgia, United States of America
| | | | - Jean A. Welsh
- Department of Epidemiology, Emory University, Atlanta, Georgia, United States of America
- School of Medicine, Emory University, Atlanta, Georgia, United States of America
| | - Julie A. Gazmararian
- Department of Epidemiology, Emory University, Atlanta, Georgia, United States of America
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Abstract
Although type 2 diabetes is a disease often associated with aging, the global prevalence of early-onset diabetes has been increasing due to man's sedentary lifestyle, low-physical activity, obesity, and some nonmodifiable risk factors. Many studies have found that individuals with early-onset type 2 diabetes were at higher risk of developing vascular complications than those with late-onset diabetes. Individuals with early-onset diabetes are usually unwilling to visit hospital and have more confidence in their health, which results in poor glycemic control and the delayed detection of diabetes-related complications. Few studies have focused on the treatment and prevention of complications in specific population of individuals with early-onset type 2 diabetes. Therefore, focusing on this particular population is critical for the government and academic societies. Screening for T2DM is imminent for young adults with a family history of diabetes, obesity, markers of insulin resistance, or alcohol consumption. More data are definitely required to establish a reasonable risk model to screen for early-onset diabetes.
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Affiliation(s)
- Jiemin Pan
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai, 200233, China
| | - Weiping Jia
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai, 200233, China.
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Early socioeconomic adversity and cardiometabolic risk in young adults: mediating roles of risky health lifestyle and depressive symptoms. J Behav Med 2018; 42:150-161. [PMID: 30039261 DOI: 10.1007/s10865-018-9952-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 07/14/2018] [Indexed: 02/08/2023]
Abstract
The study examined the mediating roles of risky health lifestyle and depressive symptoms in relation to childhood/adolescence adversity and young adult cardiometabolic risk with data from the National Longitudinal Study of Adolescent to Adult Health (n = 9421). Four classes of youth emerged from a latent class analysis with varying early adversity patterns: (a) both low disadvantaged SES and stressful experience (54.8%), (b) high disadvantaged SES and low stressful experience (31.0%), (c) low disadvantaged SES and high stressful experience (10.9%), and (d) both high disadvantaged SES and stressful experience (3.3%). Early adversity had multiple direct and indirect effects on CM risk for those experiencing SES-related adversities. Instead, early adversity generated mediational processes between adversity and CM risks through risky health lifestyle and depressive symptoms for those experiencing stressful experience. Implications for intervention when dealing with youths who have experienced multiple forms of early adversity are discussed.
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Caffarelli C, Santamaria F, Di Mauro D, Mastrorilli C, Montella S, Tchana B, Valerio G, Verrotti A, Valenzise M, Bernasconi S, Corsello G. Advances in pediatrics in 2017: current practices and challenges in allergy, endocrinology, gastroenterology, genetics, immunology, infectious diseases, neonatology, nephrology, neurology, pulmonology from the perspective of Italian Journal of Pediatrics. Ital J Pediatr 2018; 44:82. [PMID: 30016966 PMCID: PMC6050676 DOI: 10.1186/s13052-018-0524-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 07/03/2018] [Indexed: 11/25/2022] Open
Abstract
This review provides an overview of a remarkable number of significant studies in pediatrics that have been published over the past year in the Italian Journal of Pediatrics. We have selected information from papers presented in the Journal that deal with allergy, endocrinology, gastroenterology, genetics, immunology, infectious diseases, neonatology, nephrology, neurology, pulmonology. The relevant epidemiologic findings, and developments in prevention, diagnosis and treatment of the last year have been discussed and placed in context. We think that advances achieved in 2017 will help readers to make the future of patients better.
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Affiliation(s)
- Carlo Caffarelli
- Clinica Pediatrica, Department of Medicine and Surgery, Azienda Ospedaliera-Universitaria, University of Parma, Parma, Italy
| | - Francesca Santamaria
- Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Dora Di Mauro
- Clinica Pediatrica, Department of Medicine and Surgery, Azienda Ospedaliera-Universitaria, University of Parma, Parma, Italy
| | - Carla Mastrorilli
- Clinica Pediatrica, Department of Medicine and Surgery, Azienda Ospedaliera-Universitaria, University of Parma, Parma, Italy
| | - Silvia Montella
- Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Bertrand Tchana
- Cardiologia Pediatrica, Azienda Ospedaliera-Universitaria, Parma, Italy
| | - Giuliana Valerio
- Pediatria, Dipartimento di Scienze Motorie e del Benessere, Università di Napoli Parthenope, Naples, Italy
| | - Alberto Verrotti
- Department of Pediatrics, University of L’Aquila, L’Aquila, Italy
| | - Mariella Valenzise
- UOC Clinica Pediatrica AOU G, Martino Università di Messina, Messina, Italy
| | - Sergio Bernasconi
- Pediatrics Honorary Member University Faculty, G D’Annunzio University of Chieti-Pescara, Chieti, Italy
| | - Giovanni Corsello
- Department of Sciences for Health Promotion and Mother and Child Care “G. D’Alessandro”, University of Palermo, Palermo, Italy
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Christian P, Smith ER. Adolescent Undernutrition: Global Burden, Physiology, and Nutritional Risks. ANNALS OF NUTRITION AND METABOLISM 2018; 72:316-328. [PMID: 29730657 DOI: 10.1159/000488865] [Citation(s) in RCA: 163] [Impact Index Per Article: 27.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 03/12/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND Adolescents, comprised of 10-19 year olds, form the largest generation of young people in our history. There are an estimated 1.8 billion adolescents in the world, with 90% residing in low- and middle-income countries. The burden of disease among adolescents has its origins in infectious and injury-related causes, but nutritional deficiencies, suboptimal linear growth, and undernutrition are major public health problems, even as overweight may be on the rise in many contexts. Summary and Key Messages: Girls are most vulnerable to the influences of cultural and gender norms, which often discriminate against them. Dietary patterns and physical activity, in addition to schooling and countervailing social norms for early marriage, influence health and nutritional well-being of adolescents. Nutrient requirements - -including those for energy, protein, iron, calcium, and -others - increase in adolescence to support adequate growth and development. In settings where dietary intakes are suboptimal, anemia and micronutrient deficiencies are high. Endocrine factors are essential for promoting normal adolescent growth and are sensitive to undernutrition. Growth velocity increases during puberty when peak height velocity occurs and catch-up is possible; in girls, about 15-25% of adult height is attained. A premature pregnancy can halt linear growth and increase the risk of adverse birth outcomes. Research is needed to fill the huge data gaps related to nutrition and growth during adolescence, in addition to testing interventions during this second window of opportunity to enhance growth and development, improve human capital, and to end the intergenerational cycle of growth failure.
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Affiliation(s)
- Parul Christian
- Bill and Melinda Gates Foundation, Seattle, Washington, USA.,Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Emily R Smith
- Bill and Melinda Gates Foundation, Seattle, Washington, USA.,Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA
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Merianos AL, Jandarov RA, Khoury JC, Mahabee-Gittens EM. Tobacco Smoke Exposure Association With Lipid Profiles and Adiposity Among U.S. Adolescents. J Adolesc Health 2018; 62:463-470. [PMID: 29224987 PMCID: PMC5866739 DOI: 10.1016/j.jadohealth.2017.10.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Revised: 09/13/2017] [Accepted: 10/06/2017] [Indexed: 01/19/2023]
Abstract
PURPOSE We investigated the association between tobacco smoke exposure (TSE) as measured by serum cotinine and lipoprotein cholesterols and adiposity in adolescents. METHODS We performed a secondary analysis of 1999-2012 National Health and Nutrition Examination Survey data including participants 12-19 years old. We examined TSE: unexposed (<.05 ng/mL), passively exposed (.05-2.99 ng/mL), and actively exposed (≥3 ng/mL); lipid profiles: total cholesterol, high-density lipoprotein cholesterol (HDL-C), non-HDL-C, low-density lipoprotein cholesterol (LDL-C), and triglycerides; and adiposity: body mass index z-score (BMIZ), waist circumference (WC), and waist-to-height ratio (WHtR). Covariates were age, sex, race/ethnicity, income, diet, and physical activity. Multiple regression models were used to assess the association between TSE and lipid profile variables separately, and then TSE and adiposity measures separately, adjusting for covariates. We performed logistic regression to examine the association of TSE with body mass index and WHtR classifications. RESULTS Of the 11,550 participants, 41.7% were unexposed to tobacco smoke, 40.5% were passively exposed, and 17.8% were actively exposed. Compared with unexposed, participants with active TSE had lower total cholesterol, lower HDL-C, and higher triglycerides; higher BMIZ, higher WC, and higher WHtR; participants with passive TSE had lower HDL-C, higher total cholesterol, and higher LDL-C; higher BMIZ, higher WC, and higher WHtR. Participants actively exposed were at increased odds of being obese or WHtR ≥.65, and those passively exposed were at increased odds of being overweight, obese, or WHtR ≥.65. CONCLUSIONS Active TSE and passive TSE are differentially associated with factors within the lipid profile and adiposity, independent of covariates. TSE prevention efforts should start as early as childhood and continue throughout adolescence and adulthood.
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Affiliation(s)
- Ashley L Merianos
- School of Human Services, University of Cincinnati, Cincinnati, Ohio.
| | - Roman A Jandarov
- Division of Biostatistics and Bioinformatics, Department of Environmental Health, College of Medicine, University of Cincinnati, Cincinnati, Ohio
| | - Jane C Khoury
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, College of Medicine, University of Cincinnati, Cincinnati, Ohio
| | - E Melinda Mahabee-Gittens
- Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, College of Medicine, University of Cincinnati, Cincinnati, Ohio
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Merianos AL, Hossain MM, Khoury JC, Matt GE, Mahabee-Gittens EM. Serum Cotinine and Hemoglobin A1c Among a National Sample of Adolescents Without Known Diabetes. Nicotine Tob Res 2018; 20:474-481. [PMID: 28575471 PMCID: PMC5896452 DOI: 10.1093/ntr/ntx115] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Accepted: 05/25/2017] [Indexed: 12/16/2022]
Abstract
Introduction National data suggest tobacco smoke is positively associated with higher glycated hemoglobin (HbA1c) among adults. Our objective was to examine the association between serum cotinine and HbA1c among adolescents without known diabetes. Methods We assessed adolescents 12-19 years old (N = 11550) who participated in the 1999-2012 National Health and Nutrition Examination Survey. We applied sampling weights while performing multiple linear regression analyses. Results The prevalence of serum cotinine indicative of no tobacco smoke exposure (TSE, <0.05 ng/mL) was 43.2%, passive TSE (0.05-2.99 ng/mL) was 38.9%, and active TSE (>3 ng/mL) was 17.9% in our sample. Mean (± standard error) HbA1c in participants with no TSE was 5.16% (±0.01), passive TSE was 5.16% (±0.01), and active TSE was 5.14% (±0.01). No differences in HbA1c were found between TSE groups including sex, age, race/ethnicity, education, income, and physical activity or the fully adjusted model with waist circumference. We found cotinine × sex (p = .01) and cotinine × age (p = .02) interactions. There was an association between cotinine and HbA1c for males but not females. Within males, participants with cotinine ≥3 ng/mL (5.26 ± 0.02) had higher mean HbA1c than those with cotinine 0.05-2.99 ng/mL and <0.05 ng/mL (both 5.20 ± 0.01, p ≤ .02). The negative association between age and HbA1c was stronger for participants with cotinine ≥3 ng/mL than participants with cotinine <0.05 ng/mL. Conclusion No linear association was found between HbA1c and serum cotinine in adolescents overall after adjusting for potential confounders. Differences between TSE groups were found in males. Future research in adolescents should examine chronic TSE over time to examine the potential for development of type 2 diabetes. Implications TSE has been associated with increased risk for the development of type 2 diabetes among adults. It is unclear if this relationship holds in adolescents. We examined the association between serum cotinine and HbA1c in adolescents without known diabetes who completed the 1999-2012 National Health and Nutrition Examination Survey. Although no association was found between serum cotinine and HbA1c overall while controlling for potential confounding factors, we observed interaction effects that are indicative of TSE influencing HbA1c differentially by sex and age. Reducing TSE in adolescents should be a priority for future tobacco control efforts.
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Affiliation(s)
| | | | - Jane C Khoury
- Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
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Koebnick C, Mohan Y, Li X, Porter AH, Daley MF, Luo G, Kuizon BD. Failure to confirm high blood pressures in pediatric care-quantifying the risks of misclassification. J Clin Hypertens (Greenwich) 2018; 20:174-182. [DOI: 10.1111/jch.13159] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Revised: 08/29/2017] [Accepted: 08/31/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Corinna Koebnick
- Department of Research & Evaluation; Kaiser Permanente Southern California; Pasadena CA USA
| | - Yasmina Mohan
- Department of Research & Evaluation; Kaiser Permanente Southern California; Pasadena CA USA
| | - Xia Li
- Department of Research & Evaluation; Kaiser Permanente Southern California; Pasadena CA USA
| | - Amy H. Porter
- Los Angeles Medical Center; Kaiser Permanente Southern California; Los Angeles CA USA
| | - Matthew F. Daley
- Institute for Health Research; Kaiser Permanente Colorado; Denver CO USA
| | - Gang Luo
- Department of Biomedical Informatics and Medical Education; University of Washington; Seattle WA USA
| | - Beatriz D. Kuizon
- Los Angeles Medical Center; Kaiser Permanente Southern California; Los Angeles CA USA
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Oreskovic NM, Gallucci GO, Chase II, Milliren CE, Richmond TK. Oral health status and longitudinal cardiometabolic risk in a national sample of young adults. J Am Dent Assoc 2017; 148:930-935. [DOI: 10.1016/j.adaj.2017.09.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 09/13/2017] [Accepted: 09/18/2017] [Indexed: 10/18/2022]
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Li FF, Liu BL, Yin GP, Zhang DF, Zhai XF, Chen MY, Su XF, Wu JD, Ye L, Ma JH. Young onset type 2 diabetic patients might be more sensitive to metformin compared to late onset type 2 diabetic patients. Sci Rep 2017; 7:16382. [PMID: 29180640 PMCID: PMC5703958 DOI: 10.1038/s41598-017-16658-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 11/15/2017] [Indexed: 01/28/2023] Open
Abstract
It is unknown whether YOD (young onset diabetes) and LOD (late onset diabetes) require similar insulin doses for intensive insulin therapy with a metformin add-on to achieve glycemic control. We analyzed data from our two previously performed randomized, controlled open-label trials. Patients were randomized to receive either continuous subcutaneous insulin infusion (CSII) therapy or CSII combined with metformin therapy for 4 weeks. The studies concentrated on the differences in the insulin doses used for the two groups. We included 36 YOD (age < 40 yrs) and 152 LOD (age > 40 yrs) patients. YOD patients who received metformin combined with CSII therapy required significantly lower insulin doses to maintain euglycemic control compared to patients with LOD. A multivariate analysis, controlled for gender and the fasting blood concentration, was performed to determine the significance of the differences between groups, particularly with respect to the total and basal insulin doses. There was a trend toward improvement in β-cell function and insulin resistance in terms of ΔHOMA-B and ΔHOMA-IR in patients with YOD compared to those with LOD. Newly diagnosed T2D patients with YOD required significantly lower insulin doses, particularly basal insulin doses, to maintain glycemic control compared to the LOD patients.
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Affiliation(s)
- Feng-Fei Li
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Bing-Li Liu
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Guo-Ping Yin
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Dan-Feng Zhang
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Xiao-Fang Zhai
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Mao-Yuan Chen
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Xiao-Fei Su
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Jin-Dan Wu
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Lei Ye
- National Heart Research Institute Singapore, National Heart Centre, Singapore, Singapore
| | - Jian-Hua Ma
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China.
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Georgeson A, Lebenthal M, Catania R, Georgeson S. Obesity and elevated blood pressure in suburban student athletes. BMJ Open Sport Exerc Med 2017; 3:e000276. [PMID: 29177075 PMCID: PMC5687525 DOI: 10.1136/bmjsem-2017-000276] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2017] [Indexed: 01/20/2023] Open
Abstract
Objective To assess the prevalence of obesity and elevated blood pressure in a suburban population of middle school and high school student athletes and examine the differences from the previously published populations. Study design The Student Athlete Cardiac Evaluation Registry Study is a single-centre, community hospital-based registry study, that provided free annual preparticipation physical examinations (PPE) from 2009 to 2017. The PPE on the 906 athletes included a history, a physical examination and body metrics including height, weight and blood pressure. The blood pressure was measured with an automated blood pressure cuff and, if elevated, was remeasured using a manual blood pressure cuff with aneroid manometer. The data from the PPE were collected and analysed for prevalence of obesity, overweight and elevated blood pressure measurements. Results The prevalence of obesity was 11%, and 19% of participants were overweight. Many of the athletes had an elevated blood pressure (15%). There was a significant association (P<0.001) between weight and elevated blood pressure. Among athletes with elevated blood pressure, 50% were either obese or overweight. Conclusions There was a similar prevalence of overweight athletes in our study compared with previously published populations, but there were a lower proportion of obese athletes, which may be explained by differences in demographics. Despite the differences in study populations and the lower rate of obesity, the proportion of athletes with elevated blood pressure in our study was similar to prior populations. Weight issues and elevated blood pressure affect athletes across a range of different populations.
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Affiliation(s)
- Andrew Georgeson
- Pediatrics, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Mark Lebenthal
- Department of Cardiology, Robert Wood Johnson University Hospital Somerset, Somerville, New Jersey, USA
| | - Raymond Catania
- Department of Cardiology, Robert Wood Johnson University Hospital Somerset, Somerville, New Jersey, USA
| | - Steven Georgeson
- Department of Cardiology, Robert Wood Johnson University Hospital Somerset, Somerville, New Jersey, USA
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Brumana L, Arroyo A, Schwalbe NR, Lehtimaki S, Hipgrave DB. Maternal and child health services and an integrated, life-cycle approach to the prevention of non-communicable diseases. BMJ Glob Health 2017; 2:e000295. [PMID: 29082005 PMCID: PMC5656183 DOI: 10.1136/bmjgh-2017-000295] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2017] [Revised: 04/10/2017] [Accepted: 04/30/2017] [Indexed: 12/31/2022] Open
Abstract
Described as the ‘invisible epidemic’, non-communicable diseases (NCDs) are the world’s leading cause of death. Most are caused by preventable factors, including poor diet, tobacco use, harmful use of alcohol and physical inactivity. Diabetes, cancer and cardiovascular and chronic lung diseases were responsible for 38 million (68%) of global deaths in 2012. Since 1990, proportionate NCD mortality has increased substantially as populations have aged and communicable diseases decline. The majority of NCD deaths, especially premature NCD deaths (<70 years, 82%), occur in low-income and middle-income countries, and among poor communities within them. Addressing NCDs is recognised as central to the post-2015 agenda; accordingly, NCDs have a specific objective and target in the Sustainable Development Goals. While deaths from NCDs occur mainly in adulthood, many have their origins in early life, including through epigenetic mechanisms operating before conception. Good nutrition before conception and interventions aimed at preventing NCDs during the first 1000 days (from conception to age 2 years), childhood and adolescence may be more cost-effective than managing established NCDs in later life with costly tests and drugs. Following a life-course approach, maternal and child health interventions, before delivery and during childhood and adolescence, can prevent NCDs and should influence global health and socioeconomic development. This paper describes how such an approach may be pursued, including through the engagement of non-health sectors. It also emphasises evaluating and documenting related initiatives to underwrite systematic and evidence-based cross-sectoral engagement on NCD prevention in the future.
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Affiliation(s)
- Luisa Brumana
- UNICEF Regional Office for Latin America and the Caribbean, Panama City, Panama
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Xanthopoulos M, Tapia IE. Obesity and common respiratory diseases in children. Paediatr Respir Rev 2017; 23:68-71. [PMID: 27838161 DOI: 10.1016/j.prrv.2016.10.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Accepted: 10/04/2016] [Indexed: 01/08/2023]
Abstract
Obesity has become an important public health problem worldwide that disproportionally affects the underserved. Obesity has been associated with many diseases and unfortunately has not spared the respiratory system. Specifically, the prevalence of common respiratory problems, such as asthma and obstructive sleep apnoea, is higher in obese children. Further, the treatment outcomes of these frequent conditions is also worse in obese children compared to lean controls.
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Affiliation(s)
- Melissa Xanthopoulos
- Sleep Center, Division of Pulmonary Medicine, The Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104, USA
| | - Ignacio E Tapia
- Perelman School of Medicine at the University of Pennsylvania, Attending Physician, Sleep Center, Division of Pulmonary Medicine, The Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104, USA.
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Akseer N, Al-Gashm S, Mehta S, Mokdad A, Bhutta ZA. Global and regional trends in the nutritional status of young people: a critical and neglected age group. Ann N Y Acad Sci 2017; 1393:3-20. [DOI: 10.1111/nyas.13336] [Citation(s) in RCA: 94] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 02/17/2017] [Accepted: 02/23/2017] [Indexed: 12/31/2022]
Affiliation(s)
- Nadia Akseer
- Centre for Global Child Health; the Hospital for Sick Children; Toronto Canada
- Dalla Lana School of Public Health; University of Toronto; Toronto Canada
| | - Sara Al-Gashm
- Centre for Global Child Health; the Hospital for Sick Children; Toronto Canada
| | - Seema Mehta
- Centre for Global Child Health; the Hospital for Sick Children; Toronto Canada
| | - Ali Mokdad
- Institute of Health Metrics & Evaluation; University of Washington; Seattle Washington
| | - Zulfiqar A. Bhutta
- Centre for Global Child Health; the Hospital for Sick Children; Toronto Canada
- Dalla Lana School of Public Health; University of Toronto; Toronto Canada
- Center of Excellence in Women and Child Health; the Aga Khan University; Karachi Pakistan
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Bae D, Wickrama KAS. Stress Processes Linking Parent-Child Disconnection to Disease Risk in Young Adulthood: Amplification by Genotype. J Youth Adolesc 2017; 46:1137-1148. [PMID: 28343261 DOI: 10.1007/s10964-017-0666-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Accepted: 03/18/2017] [Indexed: 02/04/2023]
Abstract
Previous studies have documented that early stressful family relationships influence subsequent stressful life circumstances and health outcomes over the life course. Less is known, however, about whether stressful parent-child relationships increase the influence of proximal stressors on youth health operating as a stress-sensitizing life context, and individual genetic variations have effects on these developmental processes. Informed by life course stress process theory, which focuses on the proliferation, accumulation, and interactions of stressors over the life course as health risks, we examined whether (a) parent-child disconnection influences the occurrence of stressful life events in young adulthood, (b) parent-child disconnection potentiates the impact of stressful life events on young adults' health, or (c) potential health impact is intensified further by individual genotype. Using longitudinal data from a nationally representative sample of 11,290 adolescents (Mean age 15.5 years, 53% female) over a period of 13 years, we found parent-child disconnection influenced young adults' stressful life events and amplified the impact of stressful life events on cardio-metabolic disease risk. We also found the association between stressful life events and cardio-metabolic disease risk was further intensified by the 5-HTTLPR polymorphism. Our findings demonstrate that stressful family relationships not only initiate stress processes over the early life course, but also sensitize youth to stressors, and that 5-HTTLPR polymorphism interacts with stressful life experiences to predict heightened disease risk.
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Affiliation(s)
- Dayoung Bae
- Center for Family Research, 1095 College Station Road, Athens, 30602, GA, USA.
| | - Kandauda A S Wickrama
- Department of Human Development and Family Science, The University of Georgia, Athens, GA, USA
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Wickrama KAS, Bae D, O'Neal CW. Explaining the Association between Early Adversity and Young Adults' Diabetes Outcomes: Physiological, Psychological, and Behavioral Mechanisms. J Youth Adolesc 2017; 46:2407-2420. [PMID: 28144816 DOI: 10.1007/s10964-017-0639-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Accepted: 01/20/2017] [Indexed: 11/27/2022]
Abstract
Previous studies have documented that early adversity increases young adults' risk for diabetes resulting in morbidity and comorbidity with adverse health conditions. However, less is known about how inter-related physiological (e.g., body mass index [BMI]), psychological (e.g., depressive symptoms), and behavioral mechanisms (e.g., unhealthy eating and sedentary behavior) link early adversity to young adults' diabetes outcomes, although these mechanisms appear to stem from early stressful experiences. The current study tested the patterning of these longitudinal pathways leading to young adults' diabetes using a nationally representative sample of 13,286 adolescents (54% female) over a period of 13 years. The findings indicated that early adversity contributed to elevated BMI, depressive symptoms, and stress-related health behaviors. The impact of these linking mechanisms on hierarchical diabetes outcomes (i.e., prediabetes and diabetes) remained significant after taking their associations with each other into account, showing that these mechanisms operate concurrently. The findings emphasize the importance of early detection for risk factors of young adults' diabetes in order to minimize their detrimental health effects.
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Affiliation(s)
- Kandauda A S Wickrama
- Department of Human Development and Family Science, The University of Georgia, Athens, GA, USA
| | - Dayoung Bae
- Center for Family Research, The University of Georgia, 1095 College Station Road, Athens, GA, 30602, USA.
| | - Catherine Walker O'Neal
- Department of Human Development and Family Science, The University of Georgia, Athens, GA, USA
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