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Singh A, Kinnebrew G, Hsu PC, Weng DY, Song MA, Reisinger SA, McElroy JP, Keller-Hamilton B, Ferketich AK, Freudenheim JL, Shields PG. Untargeted Metabolomics and Body Mass in Adolescents: A Cross-Sectional and Longitudinal Analysis. Metabolites 2023; 13:899. [PMID: 37623843 PMCID: PMC10456720 DOI: 10.3390/metabo13080899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 07/25/2023] [Accepted: 07/27/2023] [Indexed: 08/26/2023] Open
Abstract
Obesity in children and adolescents has increased globally. Increased body mass index (BMI) during adolescence carries significant long-term adverse health outcomes, including chronic diseases such as cardiovascular disease, stroke, diabetes, and cancer. Little is known about the metabolic consequences of changes in BMI in adolescents outside of typical clinical parameters. Here, we used untargeted metabolomics to assess changing BMI in male adolescents. Untargeted metabolomic profiling was performed on urine samples from 360 adolescents using UPLC-QTOF-MS. The study includes a baseline of 235 subjects in a discovery set and 125 subjects in a validation set. Of them, a follow-up of 81 subjects (1 year later) as a replication set was studied. Linear regression analysis models were used to estimate the associations of metabolic features with BMI z-score in the discovery and validation sets, after adjusting for age, race, and total energy intake (kcal) at false-discovery-rate correction (FDR) ≤ 0.1. We identified 221 and 16 significant metabolic features in the discovery and in the validation set, respectively. The metabolites associated with BMI z-score in validation sets are glycylproline, citrulline, 4-vinylsyringol, 3'-sialyllactose, estrone sulfate, carnosine, formiminoglutamic acid, 4-hydroxyproline, hydroxyprolyl-asparagine, 2-hexenoylcarnitine, L-glutamine, inosine, N-(2-Hydroxyphenyl) acetamide glucuronide, and galactosylhydroxylysine. Of those 16 features, 9 significant metabolic features were associated with a positive change in BMI in the replication set 1 year later. Histidine and arginine metabolism were the most affected metabolic pathways. Our findings suggest that obesity and its metabolic outcomes in the urine metabolome of children are linked to altered amino acids, lipid, and carbohydrate metabolism. These identified metabolites may serve as biomarkers and aid in the investigation of obesity's underlying pathological mechanisms. Whether these features are associated with the development of obesity, or a consequence of changing BMI, requires further study.
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Affiliation(s)
- Amarnath Singh
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210-1240, USA; (A.S.); (D.Y.W.)
| | - Garrett Kinnebrew
- Department of Biomedical Informatics, Biomedical Informatics Shared Resources (BISR), The Ohio State University, Columbus, OH 43210-1240, USA;
| | - Ping-Ching Hsu
- Department of Environmental Health Sciences, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA;
| | - Daniel Y. Weng
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210-1240, USA; (A.S.); (D.Y.W.)
| | - Min-Ae Song
- College of Public Health, The Ohio State University, Columbus, OH 43210-1240, USA; (M.-A.S.); (A.K.F.)
| | - Sarah A. Reisinger
- Center for Tobacco Research, Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210-1240, USA; (S.A.R.); (B.K.-H.)
| | - Joseph P. McElroy
- Center for Biostatistics, Department of Biomedical Informatics, The Ohio State University, Columbus, OH 43210-1240, USA;
| | - Brittney Keller-Hamilton
- Center for Tobacco Research, Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210-1240, USA; (S.A.R.); (B.K.-H.)
- Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH 43210-1240, USA
| | - Amy K. Ferketich
- College of Public Health, The Ohio State University, Columbus, OH 43210-1240, USA; (M.-A.S.); (A.K.F.)
| | - Jo L. Freudenheim
- Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, NY 14214, USA;
| | - Peter G. Shields
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210-1240, USA; (A.S.); (D.Y.W.)
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Keller-Hamilton B, Curran H, Stevens EM, Slater MD, Lu B, Roberts ME, Ferketich AK. Associations between Cognitive and Affective Responses to Tobacco Advertisements and Tobacco Use Incidence: A Four-Year Prospective Study among Adolescent Boys. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:11666. [PMID: 34770180 PMCID: PMC8582641 DOI: 10.3390/ijerph182111666] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 11/01/2021] [Accepted: 11/03/2021] [Indexed: 11/16/2022]
Abstract
Exposure to tobacco advertisements is associated with initiation of tobacco use among youth. The mechanisms underlying this association are less clear. We estimated longitudinal associations between youths' cognitive and affective responses to advertisements for cigarettes, e-cigarettes, and smokeless tobacco (SLT) and initiation of these products. N = 1220 Ohio-residing boys of ages 11-16 were recruited into a cohort in 2015 and 2016. Participants completed surveys every six months for four years. Surveys assessed cognitive and affective responses to tobacco advertisements (which included health warnings) and tobacco use after an advertisement viewing activity. We used mixed-effects Poisson regression models with robust standard errors to estimate risk of initiating use of each tobacco product according to participants' cognitive (i.e., memorability of health risks) and affective (i.e., likability of advertisement) responses to advertisements for that product. No associations between affective responses to advertisements and tobacco use outcomes were detected in adjusted models. However, finding health risks memorable was associated with reduced risk of ever smoking initiation (aRR = 0.57; 95% CI: 0.34, 0.95) and a reduced risk of ever SLT initiation that approached statistical significance (aRR = 0.61; 95% CI: 0.36, 1.05). Measures to increase saliency of health risks on cigarette and SLT advertisements might reduce use among youth.
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Affiliation(s)
- Brittney Keller-Hamilton
- Division of Medical Oncology, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH 43214, USA
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, OH 43214, USA
| | - Hayley Curran
- Division of Epidemiology, The Ohio State University College of Public Health, Columbus, OH 43210, USA; (H.C.); (A.K.F.)
| | - Elise M. Stevens
- Division of Preventive and Behavioral Medicine, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA 01605, USA;
| | - Michael D. Slater
- School of Communication, The Ohio State University College of Arts and Sciences, Columbus, OH 43210, USA;
| | - Bo Lu
- Division of Biostatistics, The Ohio State University College of Public Health, Columbus, OH 43210, USA;
| | - Megan E. Roberts
- Division of Health Behavior and Health Promotion, The Ohio State University College of Public Health, Columbus, OH 43210, USA;
| | - Amy K. Ferketich
- Division of Epidemiology, The Ohio State University College of Public Health, Columbus, OH 43210, USA; (H.C.); (A.K.F.)
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Epperson AE, Wong S, Lambin EF, Henriksen L, Baiocchi M, Flora JA, Prochaska JJ. Adolescents' Health Perceptions of Natural American Spirit's On-the-Pack Eco-Friendly Campaign. J Adolesc Health 2021; 68:604-611. [PMID: 32713741 PMCID: PMC7855194 DOI: 10.1016/j.jadohealth.2020.06.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 06/16/2020] [Accepted: 06/16/2020] [Indexed: 11/20/2022]
Abstract
PURPOSE Natural American Spirit (NAS) cigarettes, which have recently grown in popularity, are marketed as eco-friendly and natural. The present study examined whether NAS's on-the-pack messaging influences adolescents' health perceptions of the brand. METHODS In a mixed-factor design, adolescent participants (N = 1,003, ages 13-17, 75% female) were randomized to one of the six exposure conditions. All viewed images of an NAS and a Pall Mall (comparison brand) cigarette pack, but differed in pack color (blue, green, or gold/orange) and brand viewed first. Perceptions of pack logos, addictiveness, harms to the smoker, others, and the environment were assessed directly after viewing pack images for each brand. RESULTS Adolescents who perceived NAS as more pro-environment tended to perceive NAS cigarettes to be less addictive, r = -.19, p < .01. NAS cigarettes also were perceived as less addictive and better for the environment than Pall Mall. Most (90%) participants provided nature-friendly words (e.g., environment, recycle) when asked to describe logos on the NAS packs. In adjusted models, relative to Pall Mall, NAS was perceived as healthier for smokers, healthier for smokers' family and friends, and safer for the environment. Findings did not differ by pack color and ever tobacco use. CONCLUSIONS Adolescents perceived a health advantage for NAS cigarettes with its on-the-pack, eco-friendly and pro-health marketing. The findings are consistent with prior research with adults. Given the accumulating evidence of consumer misperceptions, eco-friendly messaging on cigarettes is a public health concern that warrants further consideration for regulatory intervention.
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Affiliation(s)
- Anna E Epperson
- Division of Adolescent Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, California
| | - Samantha Wong
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - Eric F Lambin
- School of Earth, Energy & Environmental Sciences, and Woods Institute for the Environment, Stanford University, Stanford, California; Georges Lemaître Earth and Climate Research Centre, Earth and Life Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Lisa Henriksen
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - Michael Baiocchi
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - June A Flora
- Solutions Science Lab, Department of Pediatrics, Stanford University, Stanford, California
| | - Judith J Prochaska
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, California.
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