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Martínez-Ezquerro JD, Ortiz-Ramírez M, García-de la Torre P, González-Covarrubias V, Sánchez-García S. Physical Performance and Telomere Length in Older Adults. Arch Med Res 2024; 55:103046. [PMID: 39013263 DOI: 10.1016/j.arcmed.2024.103046] [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: 12/12/2023] [Revised: 06/19/2024] [Accepted: 07/05/2024] [Indexed: 07/18/2024]
Abstract
BACKGROUND The aging population prompts studying risk factors and markers to predict healthy aging. Telomere length is a promising candidate for assessing various age-related traits. AIM OF THE STUDY To investigate the association between physical performance and telomere length. METHODS We enrolled 323 older Mexican adults from the "Cohort of Obesity, Sarcopenia, and Frailty of Older Mexican Adults" affiliated with the Instituto Mexicano del Seguro Social and assessed their physical performance using the Short Physical Performance Battery, dividing participants into low (≤7) and high (>7) groups. Absolute telomere length was determined by qPCR, and individuals were classified into short (≤4.22 kb) and long (>4.22 kb) groups. We calculated the mean and adjusted mean, considering sex and age, among others, with 95% CI. We estimated the effect size between physical performance and telomere length using Cohen's d for unequal group sizes and calculated the odds ratio for physical performance based on telomere length. RESULTS Participants with low physical performance had significantly shorter telomeres (mean 4.14.44.7 kb, adjusted mean 3.54.04.5 kb, p <0.001), while those with high physical performance exhibited longer telomeres (mean 5.55.75.9 kb, adjusted mean 4.75.35.8 kb, p <0.001), with a medium-to-high telomere length effect size (d = 0.762). The odds of low physical activity increased 2.13.66.1-fold per kb of telomere attrition (adjOR 1.73.36.3, p <0.001). CONCLUSION Decreased physical function is associated with shorter telomere length. Absolute telomere length presents a promising biomarker for distinguishing between healthy and unhealthy aging, warranting further investigation.
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Affiliation(s)
- José Darío Martínez-Ezquerro
- Unidad de Investigación Epidemiológica y en Servicios de Salud, Área Envejecimiento, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico; Posgrado en Ciencias Biológicas, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Mauricio Ortiz-Ramírez
- Unidad de Investigación Epidemiológica y en Servicios de Salud, Área Envejecimiento, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Paola García-de la Torre
- Unidad de Investigación Epidemiológica y en Servicios de Salud, Área Envejecimiento, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | | | - Sergio Sánchez-García
- Unidad de Investigación Epidemiológica y en Servicios de Salud, Área Envejecimiento, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
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Franco M, Facchini L, Sacerdote C, Masala G, Manfredi L, Dansero L, Bendinelli B, Assedi M, Vitale V, Pala V, Caini S, Ricceri F. Physical activity modification over time according to socioeconomic position: results from the EPIC-Italy cohort study. BMJ Open Sport Exerc Med 2024; 10:e001957. [PMID: 39224205 PMCID: PMC11367325 DOI: 10.1136/bmjsem-2024-001957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2024] [Indexed: 09/04/2024] Open
Abstract
Objectives Our study aimed to investigate how physical activity (PA) changes over an 11-year follow-up among adults from different socioeconomic positions (SEP) near retirement age. Moreover, an analysis of different PA types is considered. Methods We used data from the EPIC-Italy cohort. We evaluated PA using the Cambridge Physical Activity Index (CPAI) and the metabolic equivalent of tasks (MET) per hour of activity for recreational PA and household PA. Educational level was assessed using the Relative Index of Inequality (RII). Occupational classes were classified according to LIFEPATH Consortium knowledge. Logistic regression was used to analyse PA among SEP and changes during follow-up. Analyses were also conducted separately for sex. Results The higher educated were more prevalent in the higher quartile of recreational PA than the lower educated both at baseline and follow-up (37% vs 28% and 37% vs 27%, respectively). At the baseline, the lower educated had a higher risk of being physically inactive than the higher educated based on recreational PA (overall OR: 1.50, 95% CI 1.40 to 1.60). Manual workers did not show a higher risk of less PA than professionals/managers (overall OR: 1.03, 95% CI 0.91 to 1.16).At follow-up, the lower educated and manual workers showed a higher risk of being physically inactive (lower educated OR: 1.46, 95% CI 1.37 to 1.56; manual worker OR: 1.33, 95% CI 1.18 to 1.50). The analyses of changes in PA showed that those who were less educated or manual workers had a higher risk of worsening their PA during the follow-up period, particularly women in recreational PA and men in CPAI measurement. Conclusion Individuals who had a disadvantaged SEP showed a higher risk of performing less PA over time.
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Affiliation(s)
- Matteo Franco
- Department of Clinical and Biological Sciences, University of Turin, Orbassano, Turin, Italy
| | - Luigi Facchini
- Institute for Cancer Research, Prevention and Clinical Network - ISPRO, Florence, Italy
| | - Carlotta Sacerdote
- Unit of Cancer Epidemiology, Città Della Salute e Della Scienza University-Hospital and Center for Cancer Prevention (CPO), Città della Salute, Turin, Italy
| | - Giovanna Masala
- Institute for Cancer Research, Prevention and Clinical Network - ISPRO, Florence, Italy
| | - Luca Manfredi
- Department of Clinical and Biological Sciences, University of Turin, Orbassano, Turin, Italy
| | - Lucia Dansero
- Department of Clinical and Biological Sciences, University of Turin, Orbassano, Turin, Italy
| | - Benedetta Bendinelli
- Institute for Cancer Research, Prevention and Clinical Network - ISPRO, Florence, Italy
| | - Melania Assedi
- Institute for Cancer Research, Prevention and Clinical Network - ISPRO, Florence, Italy
| | - Valentina Vitale
- Department of Research, Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Valeria Pala
- Department of Research, Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Saverio Caini
- Institute for Cancer Research, Prevention and Clinical Network - ISPRO, Florence, Italy
| | - Fulvio Ricceri
- Department of Clinical and Biological Sciences, University of Turin, Orbassano, Turin, Italy
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Barboza-Solis C, Herrero R, Fantin R. Health inequalities in a middle-income country: a systematic review of the Costa Rican case. Front Public Health 2024; 12:1397576. [PMID: 39234081 PMCID: PMC11373478 DOI: 10.3389/fpubh.2024.1397576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 07/23/2024] [Indexed: 09/06/2024] Open
Abstract
Objective This study systematically reviews evidence of socioeconomic health disparities in Costa Rica, a middle-income country, to elucidate the relationship between socioeconomic status and health outcomes. Methods Published studies were identified through a systematic review of PubMed (English) and Scielo (Spanish) databases from December 2023 to January 2024, following PRISMA guidelines. Search terms included socioeconomic status, social determinants, social gradient in health, and health inequalities. Results Of 236 identified references, 55 met the inclusion criteria. Findings were categorized into health inequalities in mortality (among the general population, infants, and older adults), life expectancy, cause-specific mortality, and health determinants or risk factors mediating the association between the social environment and health. The studies indicate higher mortality among the most disadvantaged groups, including deaths from respiratory diseases, violence, and infections. Higher socioeconomic status was associated with lower mortality rates in the 1990s, indicating a positive social gradient in health (RII = 1.3, CI [1.1-1.5]). Disparities were less pronounced among older adults. Urban areas exhibited concentrated wealth and increased risky behaviors, while rural areas, despite greater socioeconomic deprivation, showed a lower prevalence of risky behaviors. Regarding smoking, people living in rural areas smoked significantly less than those in urban areas (7% vs. 10%). Despite the relatively equitable distribution of public primary healthcare, disparities persisted in the timely diagnosis and treatment of chronic diseases. Cancer survival rates post-diagnosis were positively correlated with the wealth of districts (1.23 [1.12-1.35] for all cancers combined). Conclusion The study highlights the existence of social health inequalities in Costa Rica. However, despite being one of the most unequal OECD countries, Costa Rica shows relatively modest social gradients in health compared to other middle and high-income nations. This phenomenon can be attributed to distinctive social patterns in health behaviors and the equalizing influence of the universal healthcare system.
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Affiliation(s)
| | - Rolando Herrero
- Agencia Costarricense de Investigaciones Biomédicas, Fundación INCIENSA, San José, Costa Rica
| | - Romain Fantin
- Agencia Costarricense de Investigaciones Biomédicas, Fundación INCIENSA, San José, Costa Rica
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La Porta CAM, Zapperi S. Health and income inequality: a comparative analysis of USA and Italy. Front Public Health 2024; 12:1421509. [PMID: 39171297 PMCID: PMC11335724 DOI: 10.3389/fpubh.2024.1421509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Accepted: 07/23/2024] [Indexed: 08/23/2024] Open
Abstract
Introduction Socio-economic background is often an important determinant for health with low income households having higher exposure to risk factors and diminished access to healthcare and prevention, in a way that is specific to each country. Methods Here, we perform a comparative analysis of the relations between health and income inequality in two developed countries, USA and Italy, using longitudinal and cross-sectional data from surveys. Results and discussion We show that the income class determines the incidence of chronic pathologies, associated risk-factors and psychiatric conditions, but find striking differences in health inequality between the two countries. We then focus our attention on a fraction of very disadvantaged households in the USA whose income in persistently at the bottom of the distribution over a span of 20 years and which is shown to display particularly dire health conditions. Low income people in the USA also display comorbidity patterns that are not found in higher income people, while in Italy income appears to be less relevant for comorbidity. Taken together our findings illustrate how differences in lifestyle and the healthcare systems affect health inequality.
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Affiliation(s)
- Caterina A. M. La Porta
- Center for Complexity and Biosystems and Center for Innovation for Well-Being And Environment, Department of Environmental Science and Policy, University of Milan, Milan, Italy
- UOC Maxillo-Facial Surgery and Dentistry, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Stefano Zapperi
- Center for Complexity and Biosystems, Department of Physics “Aldo Pontremoli”, University of Milan, Milan, Italy
- CNR—Consiglio Nazionale delle Ricerche, Istituto di Chimica della Materia Condensata e di Tecnologie per l'Energia, Milan, Italy
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Merlin F, Giroux É. Narratives in exposomics: A reversed heuristic determinism? HISTORY AND PHILOSOPHY OF THE LIFE SCIENCES 2024; 46:22. [PMID: 38922522 DOI: 10.1007/s40656-024-00620-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 05/19/2024] [Indexed: 06/27/2024]
Abstract
Since the completion of the Human Genome Project (HGP), biomedical sciences have moved away from a gene-centred view and towards a multi-factorial one in which environment, broadly speaking, plays a central role in the determination of human health and disease. Environmental exposures have been shown to be highly prevalent in disease causation. They are considered as complementary to genetic factors in the etiology of diseases, hence the introduction of the concept of the "exposome" as encompassing the totality of human environmental exposures, from conception onwards (Wild in Cancer Epidemiol Biomark Prev 14:1847-1850, 2005), and the launch of the Human Exposome Project (HEP) which aims to complement the HGP. At first sight, and seen as complementary to the genome, the exposome could thus appear as contributing to the rise of novel postgenomic deterministic narratives which place the environment at their core. Is this really the case? If so, what sort of determinism is at work in exposomics research? Is it a case of environmental determinism, and if so, in what sense? Or is it a new sort of deterministic view? In this paper, we first show that causal narratives in exposomics are still very similar to gene-centred deterministic narratives. They correspond to a form of Laplacian determinism and, above all, to what Claude Bernard called the "determinism of a phenomenon". Second, we introduce the notion of "reversed heuristic determinism" to characterize the specific deterministic narratives present in exposomics. Indeed, the accepted sorts of external environmental exposures conceived as being at the origins of diseases are determined, methodologically speaking, by their identifiable internal and biological markers. We conclude by highlighting the most relevant implications of the presence of this heuristic determinism in exposomics research.
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Affiliation(s)
- Francesca Merlin
- Institut d'histoire et de philosophie des sciences et des techniques (UMR 8590), CNRS & Université Paris 1 Panthéon-Sorbonne, Paris, France.
| | - Élodie Giroux
- Université Jean Moulin Lyon 3 et Institut de Recherches Philosophiques de Lyon (UR 4187), Lyon, France
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Atula M, Atula T, Aro K, Irjala H, Halme E, Jouppila-Mättö A, Koivunen P, Wilkman T, Mäkitie A, Elovainio M, Pulkki-Råback L. Psychosocial factors and patient and healthcare delays in large (class T3-T4) oral, oropharyngeal, and laryngeal carcinomas. BMC Cancer 2024; 24:760. [PMID: 38914952 PMCID: PMC11197283 DOI: 10.1186/s12885-024-12517-x] [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: 02/29/2024] [Accepted: 06/14/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND Psychosocial factors and socioeconomic status have been associated with incidence, survival, and quality of life among patients with head and neck cancer. We investigated the association between different psychosocial factors, socioeconomic status, and patient delays in T3-T4 oral, oropharyngeal, and laryngeal cancer. PATIENTS AND METHODS We conducted a nationwide prospective questionnaire-based study (n = 203) over a 3-year period. RESULTS We found no association between psychosocial factors (depression, social isolation, loneliness, and cynical hostility) and patient delay. Depression was three times more common among head and neck cancer patients compared with the general Finnish population. Head and neck cancer patients had lower educational levels and employment status, and were more often current smokers and heavy drinkers. CONCLUSIONS Although we found no association between patient delay and psychosocial factors, patients diagnosed with a large head and neck cancer appeared to have a lower socioeconomic status and higher risk for developing depression, which should be considered in clinical practice.
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Affiliation(s)
- Markus Atula
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Helsinki, Helsinki University Hospital, P.O.Box 263, Helsinki, HUS, FI-00029, Finland.
| | - Timo Atula
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Helsinki, Helsinki University Hospital, P.O.Box 263, Helsinki, HUS, FI-00029, Finland
| | - Katri Aro
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Helsinki, Helsinki University Hospital, P.O.Box 263, Helsinki, HUS, FI-00029, Finland
| | - Heikki Irjala
- Department of Otorhinolaryngology-Head and Neck Surgery, Turku University Hospital, University of Turku, Turku, Finland
| | - Elina Halme
- Department of Otorhinolaryngology-Head and Neck Surgery, Tampere University Hospital, University of Tampere, Tampere, Finland
| | - Anna Jouppila-Mättö
- Department of Otorhinolaryngology-Head and Neck Surgery, Kuopio University Hospital, University of Eastern Finland, Kuopio, Finland
| | - Petri Koivunen
- Department of Otorhinolaryngology-Head and Neck Surgery, Oulu University Hospital, University of Oulu, Oulu, Finland
- PEDEGO Research Unit, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu, Finland
| | - Tommy Wilkman
- Department of Oral and Maxillofacial Surgery, University of Helsinki, Helsinki University Hospital, Helsinki, Finland
| | - Antti Mäkitie
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Helsinki, Helsinki University Hospital, P.O.Box 263, Helsinki, HUS, FI-00029, Finland
- Department of Clinical Sciences, Intervention and Technology, Division of Ear, Nose and Throat Diseases, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
- Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Marko Elovainio
- Research Program Unit, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Laura Pulkki-Råback
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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Kanmodi KK, Amzat J, Aminu K. Theories, determinants, and intervention models and approaches on inequalities of undernutrition amongst under fives: A literature review. Health Sci Rep 2024; 7:e2078. [PMID: 38690007 PMCID: PMC11058263 DOI: 10.1002/hsr2.2078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 04/10/2024] [Accepted: 04/14/2024] [Indexed: 05/02/2024] Open
Abstract
Background and Aims One of the greatest public health problems of the 21st century is undernutrition in children under the age of 5 years (CAUFY). Globally, over 232 million CUAFY are undernourished and approximately 45% of mortality in this population are undernutrition-induced. This paper reviewed and critically explained the factors perpetuating undernutrition in CUAFY in the global space. It further explained the multi-level determinants that influence health inequalities and consequently exacerbate undernutrition amongst CUAFY globally. It also went further to explain the intervention models and approaches that can be used to tackle undernutrition in CUAFY. Methods/Literature Search Strategy Demiris et al.'s approach to narrative review was utilized for this paper. Relevant articles on child nutrition were retrieved from multiple credible databases and websites of foremost health organizations. Using an iterative process, multiple combinations of search terms were done by stringing relevant key terms and their synonyms with Boolean Operators. This process was constantly refined to align search results with the study aim. Database search produced relevant and resourceful publications which were utilized to develop this review. Results The global burden of undernutrition remains high, especially in Oceania with the highest prevalence of stunting and wasting (41.4% and 12.5%), with Africa and Asia following closely. Malnutrition eradication is a global health issue of high priority as demonstrated by the "Goal 2" of the Sustainable Development Goals (SDGs), and the United Nations (UN) Decade of Action on Nutrition 2016-2025. The review identified no significant positive outcome from previous interventions due to the endemic health inequalities. Determinants of the multi-level health inequalities associated with undernutrition in CUAFY, and probable solutions are explained with theoretical models of health inequalities. A diagonal intervention approach was proposed as a viable solution to ending undernutrition in CUAFY. Conclusion The application of relevant theoretical models and context-specific intervention approaches can be utilized by stakeholders to close the existing inequality gaps, thereby reducing undernutrition amongst CUAFY globally.
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Affiliation(s)
- Kehinde Kazeem Kanmodi
- School of DentistryUniversity of RwandaKigaliRwanda
- Child Health and Wellbeing (CHAW) ProgramCephas Health Research Initiative IncIbadanNigeria
- Faculty of DentistryUniversity of PuthisastraPhnom PenhCambodia
- School of Health and Life SciencesTeesside UniversityMiddlesbroughUK
| | - Jimoh Amzat
- Department of SociologyUsmanu Danfodiyo UniversitySokotoNigeria
| | - Kafayat Aminu
- Center for Child and Adolescent Mental HealthUniversity College HospitalIbadanNigeria
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Salinas-Rodríguez A, Fernández-Niño JA, Rivera-Almaraz A, Manrique-Espinoza B. Intrinsic capacity trajectories and socioeconomic inequalities in health: the contributions of wealth, education, gender, and ethnicity. Int J Equity Health 2024; 23:48. [PMID: 38462637 PMCID: PMC10926672 DOI: 10.1186/s12939-024-02136-0] [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: 08/02/2023] [Accepted: 02/25/2024] [Indexed: 03/12/2024] Open
Abstract
BACKGROUND Life-long health inequalities exert enduring impacts and are governed by social determinants crucial for achieving healthy aging. A fundamental aspect of healthy aging, intrinsic capacity, is the primary focus of this study. Our objective is to evaluate the social inequalities connected with the trajectories of intrinsic capacity, shedding light on the impacts of socioeconomic position, gender, and ethnicity. METHODS Our dynamic cohort study was rooted in three waves (2009, 2014, 2017) of the World Health Organization's Study on Global AGEing and Adult Health in Mexico. We incorporated a nationally representative sample comprising 2722 older Mexican adults aged 50 years and over. Baseline measurements of socioeconomic position, gender, and ethnicity acted as the exposure variables. We evaluated intrinsic capacity across five domains: cognition, psychological, sensory, vitality, and locomotion. The Relative Index of Inequality and Slope Index of Inequality were used to quantify socioeconomic disparities. RESULTS We discerned three distinct intrinsic capacity trajectories: steep decline, moderate decline, and slight increase. Significant disparities based on wealth, educational level, gender, and ethnicity were observed. Older adults with higher wealth and education typically exhibited a trajectory of moderate decrease or slight increase in intrinsic capacity. In stark contrast, women and indigenous individuals were more likely to experience a steeply declining trajectory. CONCLUSIONS These findings underscore the pressing need to address social determinants, minimize gender and ethnic discrimination to ensure equal access to resources and opportunities across the lifespan. It is imperative for policies and interventions to prioritize these social determinants in order to promote healthy aging and alleviate health disparities. This approach will ensure that specific demographic groups receive customized support to sustain their intrinsic capacity during their elder years.
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Affiliation(s)
- Aaron Salinas-Rodríguez
- Center for Evaluation and Surveys Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Julián Alfredo Fernández-Niño
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Room E8532, Baltimore, MD, 21205, USA.
- Department of Public Health, Universidad del Norte, Barranquilla, Atlántico, Colombia.
| | - Ana Rivera-Almaraz
- Center for Evaluation and Surveys Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Betty Manrique-Espinoza
- Center for Evaluation and Surveys Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
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Bühler N. Precision public health in the making: examining the becoming of the "social" in a Swiss environmental health population-based cohort. FRONTIERS IN SOCIOLOGY 2023; 8:1219275. [PMID: 38162929 PMCID: PMC10754959 DOI: 10.3389/fsoc.2023.1219275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 11/21/2023] [Indexed: 01/03/2024]
Abstract
Expanding the concept of "precision" or "personalized" medicine, personalized health and precision public health designate the use of various kinds of data-genomic, other omics, clinical, or those produced by individuals themselves through self-tracking-to optimize health interventions benefiting the whole population. This paper draws on an ethnography of the implementation of a population-based environmental health cohort to shed light on the reconfigurations brought about by the "personalization" of public health in Switzerland. Combining human biomonitoring and molecular epidemiology, this cohort aims to advance the science of the exposome, a notion referring to the totality of exposures to which individuals are subjected over their lifecourse. Addressing the tension between holism and reductionism, this paper points to the important gap between the promissory horizon of the exposome and the realities of practices. Situations of reductionism are defined as moments of friction and negotiation between different rationales and values, exposing what makes the science of the exposome, including its material, economic, institutional, and methodological constraints, as well as its imaginaries and values. Rather than opposing holism and reductionism, I emphasize that they constitute two sides of the same coin, as they both pragmatically enable action and produce situated versions of the social. This empirical case shows how reductionism operates at the chemical, biological, and populational levels to produce public health scientific and social values. It thus contributes to contextualizing the pragmatic and strategic choices made by scientists, as well as the values they favor, in a research environment marked by the predominance of biomedicine over public health. It shows how the reductionism of the "social environment" was made for a better social integration of the cohort into the Swiss political and scientific landscape of public health. Bringing together actors involved in public health and questions of environmental exposures, this cohort can be interpreted as a biomedicalization of public health research, as well as an attempt to socialize it through the broad category of the exposome.
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Potente C, Chumbley J, Xu W, Levitt B, Cole SW, Ravi S, Bodelet JS, Gaydosh L, Harris KM, Shanahan MJ. Socioeconomic Inequalities and Molecular Risk for Aging in Young Adulthood. Am J Epidemiol 2023; 192:1981-1990. [PMID: 37431780 PMCID: PMC10691199 DOI: 10.1093/aje/kwad155] [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: 09/01/2021] [Revised: 01/18/2023] [Accepted: 07/03/2023] [Indexed: 07/12/2023] Open
Abstract
Diverse manifestations of biological aging often reflect disparities in socioeconomic status (SES). In this paper, we examine associations between indicators of SES and an mRNA-based aging signature during young adulthood, before clinical indications of aging are common. We use data from wave V (2016-2018) of the National Longitudinal Study of Adolescent to Adult Health, a nationally representative study of adults aged 33-43 years, with transcriptomic data from a subset of 2,491 participants. Biological aging is measured using 1) a composite transcriptomic aging signature previously identified by Peters et al.'s out-of-sample meta-analysis (Nat Commun. 2015;6:8570) and 2) 9 subsets that represent functional pathways of coexpressed genes. SES refers to income, education, occupation, subjective social status, and a composite measure combining these 4 dimensions. We examine hypothesized mechanisms through which SES could affect aging: body mass index, smoking, health insurance status, difficulty paying bills, and psychosocial stress. We find that SES-especially the composite measure and income-is associated with transcriptomic aging and immune, mitochondrial, ribosomal, lysosomal, and proteomal pathways. Counterfactual mediational models suggest that the mediators partially account for these associations. The results thus reveal that numerous biological pathways associated with aging are already linked to SES in young adulthood.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Michael J Shanahan
- Correspondence to Dr. Michael J. Shanahan, Jacobs Center for Productive Youth Development, University of Zürich, Zürich, Switzerland (e-mail: )
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McCrory C, McLoughlin S, Layte R, NiCheallaigh C, O'Halloran AM, Barros H, Berkman LF, Bochud M, M Crimmins E, T Farrell M, Fraga S, Grundy E, Kelly-Irving M, Petrovic D, Seeman T, Stringhini S, Vollenveider P, Kenny RA. Towards a consensus definition of allostatic load: a multi-cohort, multi-system, multi-biomarker individual participant data (IPD) meta-analysis. Psychoneuroendocrinology 2023; 153:106117. [PMID: 37100008 PMCID: PMC10620736 DOI: 10.1016/j.psyneuen.2023.106117] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 03/16/2023] [Accepted: 04/16/2023] [Indexed: 04/28/2023]
Abstract
BACKGROUND Allostatic load (AL) is a multi-system composite index for quantifying physiological dysregulation caused by life course stressors. For over 30 years, an extensive body of research has drawn on the AL framework but has been hampered by the lack of a consistent definition. METHODS This study analyses data for 67,126 individuals aged 40-111 years participating in 13 different cohort studies and 40 biomarkers across 12 physiological systems: hypothalamic-pituitary-adrenal (HPA) axis, sympathetic-adrenal-medullary (SAM) axis, parasympathetic nervous system functioning, oxidative stress, immunological/inflammatory, cardiovascular, respiratory, lipidemia, anthropometric, glucose metabolism, kidney, and liver. We use individual-participant-data meta-analysis and exploit natural heterogeneity in the number and type of biomarkers that have been used across studies, but a common set of health outcomes (grip strength, walking speed, and self-rated health), to determine the optimal configuration of parameters to define the concept. RESULTS There was at least one biomarker within 9/12 physiological systems that was reliably and consistently associated in the hypothesised direction with the three health outcomes in the meta-analysis of these cohorts: dehydroepiandrosterone sulfate (DHEAS), low frequency-heart rate variability (LF-HRV), C-reactive protein (CRP), resting heart rate (RHR), peak expiratory flow (PEF), high density lipoprotein cholesterol (HDL-C), waist-to-height ratio (WtHR), HbA1c, and cystatin C. An index based on five biomarkers (CRP, RHR, HDL-C, WtHR and HbA1c) available in every study was found to predict an independent outcome - mortality - as well or better than more elaborate sets of biomarkers. DISCUSSION This study has identified a brief 5-item measure of AL that arguably represents a universal and efficient set of biomarkers for capturing physiological 'wear and tear' and a further biomarker (PEF) that could usefully be included in future data collection.
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Affiliation(s)
- Cathal McCrory
- The Irish Longitudinal Study on Ageing, Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Ireland.
| | - Sinead McLoughlin
- The Irish Longitudinal Study on Ageing, Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Ireland
| | - Richard Layte
- Department of Sociology, Trinity College Dublin, Ireland
| | - Cliona NiCheallaigh
- Department of Clinical Medicine, Trinity College Dublin and St James's Hospital, Ireland
| | - Aisling M O'Halloran
- The Irish Longitudinal Study on Ageing, Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Ireland
| | - Henrique Barros
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal, Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
| | - Lisa F Berkman
- Harvard Center for Population and Development Studies, Harvard. T.H. Chan School of Public Health, 9 Bow Street, Cambridge, MA 02138, USA
| | - Murielle Bochud
- Center for Primary Care and Public Health (Unisanté), Department of Epidemiology and Health Systems, University of Lausanne, Route de la Corniche 10, 1010 Lausanne, Switzerland
| | | | - Meagan T Farrell
- Harvard Center for Population and Development Studies, Harvard. T.H. Chan School of Public Health, 9 Bow Street, Cambridge, MA 02138, USA
| | - Silvia Fraga
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal, Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
| | - Emily Grundy
- Institute for Social & Economic Research, University of Essex, UK and Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Michelle Kelly-Irving
- Centre for Epidemiology and Research in Population Health (CERPOP), Université de Toulouse, Inserm-Université Paul Sabatier, Toulouse, France
| | - Dusan Petrovic
- Center for Primary Care and Public Health (Unisanté), Department of Epidemiology and Health Systems, University of Lausanne, Route de la Corniche 10, 1010 Lausanne, Switzerland
| | - Teresa Seeman
- David Geffen School of Medicine, UCLA, Los Angeles, CA 90095, USA
| | - Silvia Stringhini
- Center for Primary Care and Public Health (Unisanté), Department of Epidemiology and Health Systems, University of Lausanne, Route de la Corniche 10, 1010 Lausanne, Switzerland; Unit of Population Epidemiology, Division of Primary Care, Geneva University Hospital, Faculty of Medicine, University of Geneva, Switzerland
| | - Peter Vollenveider
- Department of Medicine, Internal Medicine, Lausanne University Hospital, Lausanne, Switzerland, University of Lausanne, Lausanne, Switzerland
| | - Rose Anne Kenny
- The Irish Longitudinal Study on Ageing, Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Ireland
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12
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Schrecker T. Downing the Master's Tools? New Research Strategies to Address Social Determinants of Health Inequalities. INTERNATIONAL JOURNAL OF SOCIAL DETERMINANTS OF HEALTH AND HEALTH SERVICES 2023:27551938231161932. [PMID: 37032455 DOI: 10.1177/27551938231161932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
A dramatic increase in the volume of research literature referencing social determinants of health (SDH) since the report of the World Health Organization Commission on the topic in 2008 has not been matched by expansion of policies and interventions to reduce health inequalities by way of SDH. This article argues that familiar hierarchies of evidence that privilege clinical epidemiology as used in evidence-based medicine are inappropriate to address SDH. They misunderstand both the range of relevant evidence and the value-based nature of standards of proof. A richer conceptual armamentarium is available; it includes several applications of the concepts of epidemiological worlds and the lifecourse, which are explained in the article. A more appropriate evidentiary approach to SDH and health inequalities requires "downing the master's tools," to adapt Audre Lorde's phrase, and instead applying a multidisciplinary approach to assessing the evidence that adequately reflects the complexity of the relevant causal pathways. Doing so is made more difficult by the power structures that shape research priorities, yet it is essential.
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Affiliation(s)
- Ted Schrecker
- Emeritus Professor of Global Health Policy, Faculty of Medical Sciences, Newcastle University, Population Health Sciences Institute, Newcastle upon Tyne, UK
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13
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Vaccarella S, Georges D, Bray F, Ginsburg O, Charvat H, Martikainen P, Brønnum-Hansen H, Deboosere P, Bopp M, Leinsalu M, Artnik B, Lorenzoni V, De Vries E, Marmot M, Vineis P, Mackenbach J, Nusselder W. Socioeconomic inequalities in cancer mortality between and within countries in Europe: a population-based study. THE LANCET REGIONAL HEALTH. EUROPE 2023; 25:100551. [PMID: 36818237 PMCID: PMC9929598 DOI: 10.1016/j.lanepe.2022.100551] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 11/03/2022] [Accepted: 11/08/2022] [Indexed: 11/29/2022]
Abstract
Background Reducing socioeconomic inequalities in cancer is a priority for the public health agenda. A systematic assessment and benchmarking of socioeconomic inequalities in cancer across many countries and over time in Europe is not yet available. Methods Census-linked, whole-of-population cancer-specific mortality data by socioeconomic position, as measured by education level, and sex were collected, harmonized, analysed, and compared across 18 countries during 1990-2015, in adults aged 40-79. We computed absolute and relative educational inequalities; temporal trends using estimated-annual-percentage-changes; the share of cancer mortality linked to educational inequalities. Findings Everywhere in Europe, lower-educated individuals have higher mortality rates for nearly all cancer-types relative to their more highly-educated counterparts, particularly for tobacco/infection-related cancers [relative risk of lung cancer mortality for lower- versus higher-educated = 2.4 (95% confidence intervals: 2.1-2.8) among men; = 1.8 (95% confidence intervals: 1.5-2.1) among women]. However, the magnitude of inequalities varies greatly by country and over time, predominantly due to differences in cancer mortality among lower-educated groups, as for many cancer-types higher-educated have more similar (and lower) rates, irrespective of the country. Inequalities were generally greater in Baltic/Central/East-Europe and smaller in South-Europe, although among women large and rising inequalities were found in North-Europe (relative risk of all cancer mortality for lower- versus higher-educated ≥1.4 in Denmark, Norway, Sweden, Finland and the England/Wales). Among men, rate differences (per 100,000 person-years) in total-cancer mortality for lower-vs-higher-educated groups ranged from 110 (Sweden) to 559 (Czech Republic); among women from approximately null (Slovenia, Italy, Spain) to 176 (Denmark). Lung cancer was the largest contributor to inequalities in total-cancer mortality (between-country range: men, 29-61%; women, 10-56%). 32% of cancer deaths in men and 16% in women (but up to 46% and 24%, respectively in Baltic/Central/East-Europe) were associated with educational inequalities. Interpretation Cancer mortality in Europe is largely driven by levels and trends of cancer mortality rates in lower-education groups. Even Nordic-countries, with a long-established tradition of equitable welfare and social justice policies, witness increases in cancer inequalities among women. These results call for a systematic measurement, monitoring and action upon the remarkable socioeconomic inequalities in cancer existing in Europe. Funding This study was done as part of the LIFEPATH project, which has received financial support from the European Commission (Horizon 2020 grant number 633666), and the DEMETRIQ project, which received support from the European Commission (grant numbers FP7-CP-FP and 278511). SV and WN were supported by the French Institut National du Cancer (INCa) (Grant number 2018-116). PM was supported by the Academy of Finland (#308247, # 345219) and the European Research Council under the European Union's Horizon 2020 research and innovation programme (grant agreement No 101019329). The work by Mall Leinsalu was supported by the Estonian Research Council (grant PRG722).
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Affiliation(s)
- Salvatore Vaccarella
- Cancer Surveillance Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Damien Georges
- Early Detection, Prevention, and Infections Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Freddie Bray
- Cancer Surveillance Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Ophira Ginsburg
- Cancer Surveillance Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France
- Center for Global Health, U.S. National Cancer Institute Maryland, USA
| | - Hadrien Charvat
- Cancer Surveillance Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Pekka Martikainen
- Population Research Unit, Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
- Max Planck Institute for Demographic Research, Rostock, Germany
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
| | - Henrik Brønnum-Hansen
- Section for Social Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Patrick Deboosere
- Department of Sociology, Interface Demography, Vrije Universiteit Brussel, 1050 Brussels, Belgium
| | - Matthias Bopp
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Mall Leinsalu
- Stockholm Centre for Health and Social Change, Södertörn University, 141 89, Huddinge, Sweden
- Department of Epidemiology and Biostatistics, National Institute for Health Development, Tallinn, Estonia
| | - Barbara Artnik
- Chair of Public Health, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | | | - Esther De Vries
- Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Pontificia Universidad Bogota, Bogota, Colombia
| | - Michael Marmot
- Department of Epidemiology and Public Health, University College London Institute of Health Equity, London, England
| | - Paolo Vineis
- School of Public Health, Imperial College, St Mary's Campus, London, England
| | - Johan Mackenbach
- Department of Public Health, Erasmus MC, PO Box 2040, 3000 CA Rotterdam, Netherlands
| | - Wilma Nusselder
- Department of Public Health, Erasmus MC, PO Box 2040, 3000 CA Rotterdam, Netherlands
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Bottaccioli AG, Bottaccioli F. Come gli stati psichici si traducono in molecole biologiche e come questo cambia la medicina e la psicologia. PSICOTERAPIA E SCIENZE UMANE 2023. [DOI: 10.3280/pu2023-001012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
Abstract
Nell'aprile del 2022 abbiamo pubblicato, su invito di una rivista internazionale di biologia molecolare, un'ampia review che riporta le principali evidenze scientifiche sul tema delle relazioni tra vita psichica e biologia, traendone alcune conclusioni di carattere generale sulla psicologia e la medicina (Bottaccioli, Bologna & Bottaccioli, 2022). Il presente articolo riprende alcuni dei passaggi fondamentali presentati in quella review e si collega a un precedente articolo pubblicato sul n. 4/2014 di Psicoterapia e Scienze Umane (Bottaccioli, 2014b), di cui rappresenta un aggiornamento. Dalla pubblicazione di quell'articolo le evidenze sperimentali e cliniche sull'influenza della psiche sui sistemi biologici si sono moltiplicate. Al tempo stesso, conosciamo meglio le vie e i meccanismi con cui gli stati psichici si traducono in biologia.
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15
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Longitudinal associations between allostatic load, pet ownership, and socioeconomic position among U.S. adults aged 50. SSM Popul Health 2023; 21:101344. [PMID: 36684398 PMCID: PMC9853381 DOI: 10.1016/j.ssmph.2023.101344] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 12/15/2022] [Accepted: 01/13/2023] [Indexed: 01/15/2023] Open
Abstract
It is hypothesized that pets provide benefits to human health by buffering the deleterious effects of stress, but varying exposure to chronic stress via social position is rarely considered in these conceptual and empirical models. Allostatic load is an index of biological and physical measures that represents cumulative wear and tear on the body via chronic stress exposure. In this study, we use the 2006-2016 waves of the Health and Retirement Study, a nationally representative, longitudinal panel survey of adults aged 50+ in the United States, to test whether and to what extent pet ownership has an impact on allostatic load, and whether pet ownership moderates the effects of socioeconomic position on allostatic load. Linear mixed effects regression models revealed that pet owners had significantly lower allostatic load scores than those who do not own pets; however, after adjusting for socioeconomic position (i.e., wealth, education, race, ethnicity, gender, marital status), the effect of pet ownership was no longer significant. We estimated a series of models stratified by sociodemographic groups to test moderation effects. Among those who had a high school education, pet owners had lower allostatic load scores, whereas among those who had attended some college, pet owners had higher scores. Among those who were aged 80+, pet owners had higher scores than those who did not own pets. These findings suggest that the magnitude of the effect of pet ownership on allostatic load may not be sufficient to counteract experiences of high chronic stress as experienced by lower-status groups. Supporting the human-animal bond may contribute to improving older adult population health if paired with efforts to address the underlying causes of population health disparities.
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16
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Malinowska JK, Żuradzki T. Towards the multileveled and processual conceptualisation of racialised individuals in biomedical research. SYNTHESE 2022; 201:11. [PMID: 36591336 PMCID: PMC9795162 DOI: 10.1007/s11229-022-04004-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 12/09/2022] [Indexed: 06/17/2023]
Abstract
In this paper, we discuss the processes of racialisation on the example of biomedical research. We argue that applying the concept of racialisation in biomedical research can be much more precise, informative and suitable than currently used categories, such as race and ethnicity. For this purpose, we construct a model of the different processes affecting and co-shaping the racialisation of an individual, and consider these in relation to biomedical research, particularly to studies on hypertension. We finish with a discussion on the potential application of our proposition to institutional guidelines on the use of racial categories in biomedical research.
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Affiliation(s)
| | - Tomasz Żuradzki
- Institute of Philosophy & Interdisciplinary Centre for Ethics, Jagiellonian University, ul. Grodzka 52, 31-044 Kraków, Poland
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17
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Vineis P. Invited Perspective: The Mysterious Case of Social Determinants of Health. ENVIRONMENTAL HEALTH PERSPECTIVES 2022; 130:111303. [PMID: 36350666 PMCID: PMC9645432 DOI: 10.1289/ehp12030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/28/2022] [Accepted: 10/07/2022] [Indexed: 06/16/2023]
Affiliation(s)
- Paolo Vineis
- Medical Research Council Centre for Environment and Health, Imperial College, London, UK
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18
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Gajardo-Araya G, Hernández-Jaña S, Olivares-Arancibia J, Ferrari G, Delgado-Floody P, Cristi-Montero C. Physical fitness mediates the inverse association between fatness indicators and academic achievement, despite the school vulnerability of adolescents—The Cogni-Action Project. Front Nutr 2022; 9:904831. [PMID: 36386944 PMCID: PMC9643798 DOI: 10.3389/fnut.2022.904831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 09/27/2022] [Indexed: 12/04/2022] Open
Abstract
Objective This study aims to determine the mediating role of physical fitness in the relationship between fatness indicators and academic achievement, exploring the influence of school vulnerability. Methods A total of 1,296 Chilean adolescents (aged 10 to 14 years; 50% girls) participated in this study. The global fitness score (GFS) was obtained by adding the three main components of the ALPHA fitness test: cardiorespiratory fitness (CRF), muscular fitness (MF), and speed/agility fitness (SAF). CRF was evaluated through the 20 m shuttle run test; MF by upper and lower limb strength tests; and SAF by the 4 × 10 shuttle run test. BMIz and WHtR were evaluated as general (unspecific) and central (specific) fatness indicators. Academic achievement was established through grades in math, language, and science and their average scores. Multiple mediation analyses were performed according to two models, adjusted for sex, maturity, and schools (model 1), and in model 2, the school vulnerability index (SVI) was added. The SVI is an important proxy of socioeconomic status at the school level, and it was categorized as high-, mid-, or low-SVI. Mediation percentages were calculated, and confidence intervals (bootstrapping) were used to establish significant findings. Results CRF, SAF, and GFS mediate the relationship between fatness indicators and academic achievement, both partially and totally (ranging from 12.7 to 59.2%). However, MF did not show any mediation effect. After controlling for SVI, CRF, and GFS, mediation changed from partial to total in the associations between math and science with WHtR. Although SAF contributed to GFS mediation, CRF seems to have the most significant mediation role for all academic achievements, regardless of SVI and the fat indicator studied. Conclusion A higher level of general physical fitness, especially CRF, significantly mediates the detrimental influence of fatness on the academic achievement of schoolchildren. This study suggests that physical fitness plays a relevant role in academic and public health, considering the high prevalence and detrimental influence of obesity and school vulnerability in children and adolescents.
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Affiliation(s)
- Guillermo Gajardo-Araya
- Magíster en Educación, Mención Política y Gestión Educativa, Facultad de Filosofía y Humanidades, Universidad Austral de Chile, Valdivia, Chile
- IRyS Group, Physical Education School, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile
| | - Sam Hernández-Jaña
- IRyS Group, Physical Education School, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile
| | - Jorge Olivares-Arancibia
- IRyS Group, Physical Education School, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile
- Grupo AFySE, Investigación en Actividad Física y Salud Escolar, Escuela de Pedagogía en Educación Física, Facultad de Educación, Universidad de Las Américas, Santiago, Chile
| | - Gerson Ferrari
- Escuela de Ciencias de la Actividad Física, el Deporte y la Salud, Universidad de Santiago de Chile (USACH), Santiago, Chile
| | - Pedro Delgado-Floody
- Department of Physical Education, Sport, and Recreation, Universidad de La Frontera, Temuco, Chile
| | - Carlos Cristi-Montero
- IRyS Group, Physical Education School, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile
- *Correspondence: Carlos Cristi-Montero,
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Freni-Sterrantino A, Fiorito G, d’Errico A, Virtanen M, Ala-Mursula L, Järvelin MR, Vineis P, Robinson O. Association between work characteristics and epigenetic age acceleration: cross-sectional results from UK - Understanding Society study. Aging (Albany NY) 2022; 14:7752-7773. [PMID: 36202116 PMCID: PMC9596217 DOI: 10.18632/aging.204327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 09/17/2022] [Indexed: 11/25/2022]
Abstract
Occupation-related stress and work characteristics are possible determinants of social inequalities in epigenetic aging but have been little investigated. Here, we investigate the association of several work characteristics with epigenetic age acceleration (AA) biomarkers. The study population included employed and unemployed men and women (n = 631) from the UK Understanding Society study. We evaluated the association of employment and work characteristics related to job type, job stability; job schedule; autonomy and influence at work; occupational physical activity; and feelings regarding the job with four epigenetic age acceleration biomarkers (Hannum, Horvath, PhenoAge, GrimAge) and pace of aging (DunedinPoAm, DunedinPACE). We fitted linear regression models, unadjusted and adjusted for established risk factors, and found the following associations for unemployment (years of acceleration): HorvathAA (1.51, 95% CI 0.08, 2.95), GrimAgeAA (1.53, 95% CI 0.16, 2.90) and 3.21 years for PhenoAA (95% CI 0.89, 5.33). Job insecurity increased PhenoAA (1.83, 95% CI 0.003, 3.67), while working at night was associated with an increase of 2.12 years in GrimAgeAA (95% CI 0.69, 3.55). We found effects of unemployment to be stronger in men and effects of night shift work to be stronger in women. These results provide evidence of associations between unemployment with accelerated ageing and suggest that insecure employment and night work may also increase age acceleration. Our findings have implications for policies relating to current changes in working conditions and highlight the utility of biological age biomarkers in studies in younger populations without long-term health information.
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Affiliation(s)
- Anna Freni-Sterrantino
- MRC Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London W2 1PG, United Kingdom,The Alan Turing Institute, John Dodson House, London NW1 2DB, United Kingdom
| | - Giovanni Fiorito
- MRC Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London W2 1PG, United Kingdom,Laboratory of Biostatistics, Department of Biomedical Sciences, University of Sassari, Sassari 07100, Italy
| | - Angelo d’Errico
- Department of Epidemiology, Local Health Unit TO 3, Turin 10095, Italy
| | - Marianna Virtanen
- School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu FI-80101, Finland,Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm 17177, Sweden
| | - Leena Ala-Mursula
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu 90014, Finland
| | - Marjo-Riitta Järvelin
- MRC Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London W2 1PG, United Kingdom,Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu 90014, Finland
| | - Paolo Vineis
- MRC Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London W2 1PG, United Kingdom
| | - Oliver Robinson
- MRC Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London W2 1PG, United Kingdom,Ageing Epidemiology (AGE) Research Unit, School of Public Health, Imperial College of London, London W2 1PG, United Kingdom
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20
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Fiorito G, Pedron S, Ochoa-Rosales C, McCrory C, Polidoro S, Zhang Y, Dugué PA, Ratliff S, Zhao WN, McKay GJ, Costa G, Solinas MG, Harris KM, Tumino R, Grioni S, Ricceri F, Panico S, Brenner H, Schwettmann L, Waldenberger M, Matias-Garcia PR, Peters A, Hodge A, Giles GG, Schmitz LL, Levine M, Smith JA, Liu Y, Kee F, Young IS, McGuinness B, McKnight AJ, van Meurs J, Voortman T, Kenny RA, Vineis P, Carmeli C. The Role of Epigenetic Clocks in Explaining Educational Inequalities in Mortality: A Multicohort Study and Meta-analysis. J Gerontol A Biol Sci Med Sci 2022; 77:1750-1759. [PMID: 35172329 PMCID: PMC10310990 DOI: 10.1093/gerona/glac041] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Indexed: 11/13/2022] Open
Abstract
Educational inequalities in all-cause mortality have been observed for decades. However, the underlying biological mechanisms are not well known. We aimed to assess the role of DNA methylation changes in blood captured by epigenetic clocks in explaining these inequalities. Data were from 8 prospective population-based cohort studies, representing 13 021 participants. First, educational inequalities and their portion explained by Horvath DNAmAge, Hannum DNAmAge, DNAmPhenoAge, and DNAmGrimAge epigenetic clocks were assessed in each cohort via counterfactual-based mediation models, on both absolute (hazard difference) and relative (hazard ratio) scales, and by sex. Second, estimates from each cohort were pooled through a random effect meta-analysis model. Men with low education had excess mortality from all causes of 57 deaths per 10 000 person-years (95% confidence interval [CI]: 38, 76) compared with their more advantaged counterparts. For women, the excess mortality was 4 deaths per 10 000 person-years (95% CI: -11, 19). On the relative scale, educational inequalities corresponded to hazard ratios of 1.33 (95% CI: 1.12, 1.57) for men and 1.15 (95% CI: 0.96, 1.37) for women. DNAmGrimAge accounted for the largest proportion, approximately 50%, of the educational inequalities for men, while the proportion was negligible for women. Most of this mediation was explained by differential effects of unhealthy lifestyles and morbidities of the World Health Organization (WHO) risk factors for premature mortality. These results support DNA methylation-based epigenetic aging as a signature of educational inequalities in life expectancy emphasizing the need for policies to address the unequal social distribution of these WHO risk factors.
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Affiliation(s)
- Giovanni Fiorito
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
- MRC Centre for Environment and Health, School of Public Health, Imperial College
London, London, UK
| | - Sara Pedron
- Institute of Health Economics and Health Care Management, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Munich, Germany
- Professorship of Public Health and Prevention, Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Carolina Ochoa-Rosales
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
- Centro de Vida Saludable de la Universidad de Conceptión, Conceptiòn, Chile
| | - Cathal McCrory
- Department of Medical Gerontology, Trinity College Dublin, Dublin, Ireland
| | | | - Yan Zhang
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Munich, Germany
| | - Pierre-Antoine Dugué
- Cancer Epidemiology Division, Cancer Council Victoria, Victoria, Australia
- Centre for Epidemiology and Biostatistics, School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Scott Ratliff
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Wei N Zhao
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Gareth J McKay
- Centre for Public Health, Queen’s University Belfast, Belfast, Northern Ireland
| | - Giuseppe Costa
- Epidemiology Unit, Regional Health Service TO3, Grugliasco, Italy
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | | | - Kathleen Mullan Harris
- Department of Sociology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Rosario Tumino
- Cancer Registry and Histopathology Department, Provincial Health Authority (ASP 7), Ragusa, Italy
| | - Sara Grioni
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Fulvio Ricceri
- Epidemiology Unit, Regional Health Service TO3, Grugliasco, Italy
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Salvatore Panico
- Dipartimento di Medicina Clinica e Chirurgia, University of Naples Federico II, Naples, Italy
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Munich, Germany
- Network Aging Research, Heidelberg University, Heidelberg, Germany
| | - Lars Schwettmann
- Institute of Health Economics and Health Care Management, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Munich, Germany
- Department of Economics, Martin Luther University, Halle-Wittenberg, Germany
| | - Melanie Waldenberger
- Research Unit Molecular Epidemiology, Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Munich, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munich, Germany
| | - Pamela R Matias-Garcia
- Research Unit Molecular Epidemiology, Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Munich, Germany
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Munich, Germany
| | - Allison Hodge
- Cancer Epidemiology Division, Cancer Council Victoria, Victoria, Australia
- Centre for Epidemiology and Biostatistics, School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Graham G Giles
- Cancer Epidemiology Division, Cancer Council Victoria, Victoria, Australia
- Centre for Epidemiology and Biostatistics, School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Lauren L Schmitz
- Robert M. La Follette School of Public Affairs, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Morgan Levine
- Department of Pathology, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Jennifer A Smith
- Centre for Public Health, Queen’s University Belfast, Belfast, Northern Ireland
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Yongmei Liu
- Division of Cardiology, Department of Medicine, School of Medicine, Duke University, Durham, North Carolina, USA
| | - Frank Kee
- Centre for Public Health, Queen’s University Belfast, Belfast, Northern Ireland
| | - Ian S Young
- Centre for Public Health, Queen’s University Belfast, Belfast, Northern Ireland
| | | | - Amy Jayne McKnight
- Centre for Public Health, Queen’s University Belfast, Belfast, Northern Ireland
| | - Joyce van Meurs
- Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Trudy Voortman
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - Rose A Kenny
- Department of Medical Gerontology, Trinity College Dublin, Dublin, Ireland
| | | | - Paolo Vineis
- MRC Centre for Environment and Health, School of Public Health, Imperial College
London, London, UK
| | - Cristian Carmeli
- Population Health Laboratory, University of Fribourg, Fribourg, Switzerland
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21
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Bidenko K, Bohnet-Joschko S. Supporting family care: a scoping app review. BMC Med Inform Decis Mak 2022; 22:162. [PMID: 35729573 PMCID: PMC9210723 DOI: 10.1186/s12911-022-01906-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 06/06/2022] [Indexed: 11/16/2022] Open
Abstract
Background Mobile applications (apps) may provide family caregivers of people with chronic diseases and conditions with access to support and good information. However, thorough understanding of how these apps meet the main needs and requirements of the users is currently lacking. The aim of this study was to review the currently available apps for family caregivers and evaluate their relevance to main domains of caregiving activities, caregivers’ personal needs, and caregivers’ groups found in previous research on family caregivers. Methods We conducted a scoping review on English-language and German-language apps for family caregivers on two major app stores: Google Play Store and iOS App Store. Apps were included if the main target group were family caregivers. Data were extracted from the app descriptions provided by the app producers in the app stores. Results The majority of the apps was designed to assist caregivers in their caregiving activities. Apps were rarely tailored to specific groups of family caregivers such as young carers and their needs. Further, apps addressing caregivers’ personal health, financial security, and work issues were scarce. Commercial apps dominated the market, often intermediating paid services or available for users of specific hardware. Public and non-profit organizations provided best-rated and free-of-charge apps but had a very limited range of services with focus on caregivers’ health and training. Conclusions Our results indicate that current apps for family caregivers do not distinguish specific groups of family caregivers, also they rarely address caregivers’ personal needs.
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Affiliation(s)
- Katharina Bidenko
- Chair of Management and Innovation in Health Care, Witten/Herdecke University, Alfred-Herrhausen-Straße 50, 58448, Witten, Germany.
| | - Sabine Bohnet-Joschko
- Chair of Management and Innovation in Health Care, Witten/Herdecke University, Alfred-Herrhausen-Straße 50, 58448, Witten, Germany
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22
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Caruso C, Ligotti ME, Accardi G, Aiello A, Duro G, Galimberti D, Candore G. How Important Are Genes to Achieve Longevity? Int J Mol Sci 2022; 23:5635. [PMID: 35628444 PMCID: PMC9145989 DOI: 10.3390/ijms23105635] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 05/13/2022] [Accepted: 05/16/2022] [Indexed: 01/25/2023] Open
Abstract
Several studies on the genetics of longevity have been reviewed in this paper. The results show that, despite efforts and new technologies, only two genes, APOE and FOXO3A, involved in the protection of cardiovascular diseases, have been shown to be associated with longevity in nearly all studies. This happens because the genetic determinants of longevity are dynamic and depend on the environmental history of a given population. In fact, population-specific genes are thought to play a greater role in the attainment of longevity than those shared between different populations. Hence, it is not surprising that GWAS replicated associations of common variants with longevity have been few, if any, as these studies pool together different populations. An alternative way might be the study of long-life families. This type of approach is proving to be an ideal resource for uncovering protective alleles and associated biological signatures for healthy aging phenotypes and exceptional longevity.
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Affiliation(s)
- Calogero Caruso
- Laboratorio di Immunopatologia e Immunosenescenza, Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università di Palermo, 90133 Palermo, Italy; (M.E.L.); (G.A.); (A.A.); (G.C.)
| | - Mattia Emanuela Ligotti
- Laboratorio di Immunopatologia e Immunosenescenza, Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università di Palermo, 90133 Palermo, Italy; (M.E.L.); (G.A.); (A.A.); (G.C.)
- Istituto per la Ricerca e l’Innovazione Biomedica, Consiglio Nazionale delle Ricerche, 90146 Palermo, Italy;
| | - Giulia Accardi
- Laboratorio di Immunopatologia e Immunosenescenza, Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università di Palermo, 90133 Palermo, Italy; (M.E.L.); (G.A.); (A.A.); (G.C.)
| | - Anna Aiello
- Laboratorio di Immunopatologia e Immunosenescenza, Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università di Palermo, 90133 Palermo, Italy; (M.E.L.); (G.A.); (A.A.); (G.C.)
| | - Giovanni Duro
- Istituto per la Ricerca e l’Innovazione Biomedica, Consiglio Nazionale delle Ricerche, 90146 Palermo, Italy;
| | | | - Giuseppina Candore
- Laboratorio di Immunopatologia e Immunosenescenza, Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università di Palermo, 90133 Palermo, Italy; (M.E.L.); (G.A.); (A.A.); (G.C.)
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23
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Bottaccioli AG, Bologna M, Bottaccioli F. Psychic Life-Biological Molecule Bidirectional Relationship: Pathways, Mechanisms, and Consequences for Medical and Psychological Sciences-A Narrative Review. Int J Mol Sci 2022; 23:3932. [PMID: 35409300 PMCID: PMC8999976 DOI: 10.3390/ijms23073932] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 03/29/2022] [Accepted: 03/29/2022] [Indexed: 02/01/2023] Open
Abstract
Today, it is possible to investigate the biological paths and mechanisms that link mental life to biological life. Emotions, feelings, desires, and cognitions influence biological systems. In recent decades, psychoneuroendocrinoimmunology research has highlighted the routes linking the psyche-brain-immune systems. Recently, epigenetics research has shown the molecular mechanisms by which stress and mental states modulate the information contained in the genome. This research shapes a new paradigm considering the human being as a whole, integrating biology and psychology. This will allow us to progress towards personalized precision medicine, deeply changing medical and psychological sciences and clinical practice. In this paper, we recognize leading research on both bidirectional relations between the psyche-brain-immunity and molecular consequences of psychological and mental states.
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Affiliation(s)
- Anna Giulia Bottaccioli
- Department of Psychology, University “Vita e Salute”, San Raffaele, 20132 Milan, Italy
- Italian Society of Psycho-Neuro-Endocrine-Immunology (SIPNEI), 00195 Rome, Italy; (M.B.); (F.B.)
| | - Mauro Bologna
- Italian Society of Psycho-Neuro-Endocrine-Immunology (SIPNEI), 00195 Rome, Italy; (M.B.); (F.B.)
- Department of Medicine, Public Health, Life and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy
| | - Francesco Bottaccioli
- Italian Society of Psycho-Neuro-Endocrine-Immunology (SIPNEI), 00195 Rome, Italy; (M.B.); (F.B.)
- Department of Medicine, Public Health, Life and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy
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24
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Freni-Sterrantino A, Fiorito G, D’Errico A, Robinson O, Virtanen M, Ala-Mursula L, Järvelin MR, Ronkainen J, Vineis P. Work-related stress and well-being in association with epigenetic age acceleration: A Northern Finland Birth Cohort 1966 Study. Aging (Albany NY) 2022; 14:1128-1156. [PMID: 35113041 PMCID: PMC8876924 DOI: 10.18632/aging.203872] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Accepted: 01/25/2022] [Indexed: 11/25/2022]
Abstract
Recent evidence indicates consistent association of low socioeconomic status with epigenetic age acceleration, measured from DNA methylation. As work characteristics and job stressors are crucial components of socioeconomic status, we investigated their association with various measures of epigenetic age acceleration. The study population included employed and unemployed men and women (n=604) from the Northern Finland Birth Cohort 1966. We investigated the association of job strain, effort-reward imbalance and work characteristics with five biomarkers of epigenetic aging (Hannum, Horvath, PhenoAge, GrimAge, and DunedinPoAm). Our results indicate few significant associations between work stress indicators and epigenetic age acceleration, limited to a range of ±2 years, and smoking recording the highest effect on GrimAge age acceleration biomarker between current and no smokers (median difference 4.73 years (IQR 1.18, 8.41). PhenoAgeAA was associated with job strain active work (β=-1.301 95%CI -2.391, -0.212), slowing aging of less than 1.5 years, and working as white-collar slowed aging six months (GrimAgeAA β=-0.683, 95%CI -1.264, -0.102) when compared to blue collars. Association was found for working for more than 40 hours per week that increased the aging over 1.5 years, (HorvathAA β =2.058 95%CI 0.517,3.599, HannumAA β=1.567, 95%CI 0.415,2.719). The pattern of associations was different between women and men and some of the estimated effects are inconsistent with current literature. Our results provide the first evidence of association of work conditions with epigenetic aging biomarkers. However, further epidemiological research is needed to fully understand how work-related stress affects epigenetic age acceleration in men and women in different societies.
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Affiliation(s)
- Anna Freni-Sterrantino
- MRC Centre for Environment and Health, Department of Epidemiology and Biostatistics, Imperial College London, St Mary's Campus, London W2 1PG, United Kingdom
| | - Giovanni Fiorito
- MRC Centre for Environment and Health, Department of Epidemiology and Biostatistics, Imperial College London, St Mary's Campus, London W2 1PG, United Kingdom
- Laboratory of Biostatistics, Department of Biomedical Sciences, University of Sassari, Sassari 07100, Italy
| | - Angelo D’Errico
- Department of Epidemiology, Local Health Unit TO 3, Turin 10095, Italy
| | - Oliver Robinson
- MRC Centre for Environment and Health, Department of Epidemiology and Biostatistics, Imperial College London, St Mary's Campus, London W2 1PG, United Kingdom
| | - Marianna Virtanen
- School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu FI-80101, Finland
- Division of Insurance Medicine, Karolinska Institutet, Stockholm 17177, Sweden
| | - Leena Ala-Mursula
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu 90014, Finland
| | - Marjo-Riitta Järvelin
- MRC Centre for Environment and Health, Department of Epidemiology and Biostatistics, Imperial College London, St Mary's Campus, London W2 1PG, United Kingdom
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu 90014, Finland
| | - Justiina Ronkainen
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu 90014, Finland
| | - Paolo Vineis
- MRC Centre for Environment and Health, Department of Epidemiology and Biostatistics, Imperial College London, St Mary's Campus, London W2 1PG, United Kingdom
- Grantham Institute for Climate Change and School of Public Health, Imperial College London, London SW7 2AZ, United Kingdom
- IIGM – Italian Institute for Genomic Medicine (IIGM), IRCCS Candiolo, Torino 10060, Italy
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25
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Verra SE, Poelman MP, Mudd AL, de Vet E, van Rongen S, de Wit J, Kamphuis CB. What’s important to you? Socioeconomic inequalities in the perceived importance of health compared to other life domains. BMC Public Health 2022; 22:86. [PMID: 35027043 PMCID: PMC8759269 DOI: 10.1186/s12889-022-12508-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 12/29/2021] [Indexed: 11/25/2022] Open
Abstract
Background Pressing issues, like financial concerns, may outweigh the importance people attach to health. This study tested whether health, compared to other life domains, was considered more important by people in high versus low socioeconomic positions, with future focus and financial strain as potential explanatory factors. Methods A cross-sectional survey was conducted in 2019 among N=1,330 Dutch adults. Participants rated the importance of two health-related domains (not being ill, living a long life) and seven other life domains (e.g., work, family) on a five-point scale. A latent class analysis grouped participants in classes with similar patterns of importance ratings. Differences in class membership according to socioeconomic position (indicated by income and education) were examined using structural equation modelling, with future focus and financial strain as mediators. Results Three classes were identified, which were defined as: neutralists, who found all domains neutral or unimportant (3.5% of the sample); hedonists, who found most domains important except living a long life, work, and religion (36.2%); and maximalists, who found nearly all domains important, including both health domains (60.3%). Of the neutralists, 38% considered not being ill important, and 30% considered living a long life important. For hedonists, this was 92% and 39%, respectively, and for maximalists this was 99% and 87%, respectively. Compared to belonging to the maximalists class, a low income predicted belonging to the neutralists, and a higher educational level and unemployment predicted belonging to the hedonists. No mediation pathways via future focus or financial strain were found. Conclusions Lower income groups were less likely to consider not being ill important. Those without paid employment and those with a higher educational level were less likely to consider living a long life important. Neither future focus nor financial strain explained these inequalities. Future research should investigate socioeconomic differences in conceptualisations of health, and if inequalities in the perceived importance of health are associated with inequalities in health. To support individuals dealing with challenging circumstances in daily life, health-promoting interventions could align to the life domains perceived important to reach their target group and to prevent widening socioeconomic health inequalities. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-12508-2.
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26
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Courtin E, Vineis P. COVID-19 as a Syndemic. Front Public Health 2021; 9:763830. [PMID: 34568273 PMCID: PMC8459739 DOI: 10.3389/fpubh.2021.763830] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 08/27/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Emilie Courtin
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Paolo Vineis
- MRC Centre for Environment and Health, Imperial College London, London, United Kingdom
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27
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Cano-Gutierrez C, Gutiérrez-Robledo LM, Lourenço R, Marín PP, Morales Martínez F, Parodi J, Mañas LR, Zúñiga Gil CH. [Old age and the new ICD-11: Position of the Latin American Academy of Medicine for Older PersonsA velhice e a nova CID-11: posição da Academia Latino-americana de Medicina do Idoso]. Rev Panam Salud Publica 2021; 45:e112. [PMID: 34413882 PMCID: PMC8369127 DOI: 10.26633/rpsp.2021.112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 07/14/2021] [Indexed: 01/10/2023] Open
Abstract
Desde 1948, la Organización Mundial de la Salud ha venido publicando un sistema codificado de causas de enfermedad y muerte bajo el nombre genérico de Clasificación Estadística Internacional de Enfermedades (CIE), con revisiones en profundidad cada 10-15 años. En su última versión, CIE-11, se utiliza una terminología para caracterizar la vejez como “períodos geriátricos inicial y final”, lo que implica una medicalización de esta etapa de la vida que ha generado confusión y polémica. En este trabajo se discute la nueva terminología propuesta a la luz del conocimiento actual en torno a la vejez y el proceso de envejecimiento, y su definición más aceptada. La CIE no solo clasifica las enfermedades sino también los períodos de la vida y los “problemas relacionados con la salud”, y la vejez por sí sola no representa un problema relacionado con la salud para muchos de quienes se encuentran en esta etapa de la vida. Desde esta perspectiva, es imprescindible cambiar o matizar el epígrafe “vejez” de la CIE-11 para que no se perciba como síntoma, signo o resultado clínico anómalo, e introducir términos que reflejen mucho mejor el estado de envejecimiento patológico. Entre los términos que gozan de un creciente soporte experimental y bibliográfico están “fragilidad” y “pérdida de la capacidad intrínseca”, que aportan mucha mayor precisión a la hora de definir la condición de la persona que no goza de un envejecimiento saludable.
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Affiliation(s)
- Carlos Cano-Gutierrez
- Pontificia Universidad Javeriana Bogotá Colombia Pontificia Universidad Javeriana, Bogotá, Colombia
| | | | - Roberto Lourenço
- Pontificia Universidad Católica de Río de Janeiro Río de Janeiro Brasil Pontificia Universidad Católica de Río de Janeiro, Río de Janeiro, Brasil
| | - Pedro Paulo Marín
- Pontificia Universidad Católica de Chile Santiago Chile Pontificia Universidad Católica de Chile, Santiago, Chile
| | | | - José Parodi
- Universidad San Martín de Porres Lima Perú Universidad San Martín de Porres, Lima, Perú
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28
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Mudd AL, van Lenthe FJ, Verra SE, Bal M, Kamphuis CBM. Socioeconomic inequalities in health behaviors: exploring mediation pathways through material conditions and time orientation. Int J Equity Health 2021; 20:184. [PMID: 34391423 PMCID: PMC8364086 DOI: 10.1186/s12939-021-01522-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 07/24/2021] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Socioeconomic inequalities in health behaviors have been attributed to both structural and individual factors, but untangling the complex, dynamic pathways through which these factors influence inequalities requires more empirical research. This study examined whether and how two factors, material conditions and time orientation, sequentially impact socioeconomic inequalities in health behaviors. METHODS Dutch adults 25 and older self-reported highest attained educational level, a measure of socioeconomic position (SEP); material conditions (financial strain, housing tenure, income); time orientation; health behaviors including smoking and sports participation; and health behavior-related outcomes including body mass index (BMI) and self-assessed health in three surveys (2004, 2011, 2014) of the longitudinal GLOBE (Dutch acronym for "Health and Living Conditions of the Population of Eindhoven and surroundings") study. Two hypothesized pathways were investigated during a ten-year time period using sequential mediation analysis, an approach that enabled correct temporal ordering and control for confounders such as baseline health behavior. RESULTS Educational level was negatively associated with BMI, positively associated with sports participation and self-assessed health, and not associated with smoking in the mediation models. For smoking, sports participation, and self-assessed health, a pathway from educational level to the outcome mediated by time orientation followed by material conditions was observed. CONCLUSIONS Time orientation followed by material conditions may play a role in determining socioeconomic inequalities in certain health behavior-related outcomes, providing empirical support for the interplay between structural and individual factors in socioeconomic inequalities in health behavior. Smoking may be determined by prior smoking behavior regardless of SEP, potentially due to its addictive nature. While intervening on time orientation in adulthood may be challenging, the results from this study suggest that policy interventions targeted at material conditions may be more effective in reducing socioeconomic inequalities in certain health behaviors when they account for time orientation.
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Affiliation(s)
- Andrea L Mudd
- Department of Interdisciplinary Social Science- Social Policy and Public Health, Utrecht University, PO Box 80140, 3508 TC, Utrecht, The Netherlands.
| | - Frank J van Lenthe
- Department of Public Health, Erasmus University Medical Centre, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
- Department of Human Geography and Spatial Planning, Utrecht University, PO Box 80140, 3508 TC, Utrecht, The Netherlands
| | - Sanne E Verra
- Department of Interdisciplinary Social Science- Social Policy and Public Health, Utrecht University, PO Box 80140, 3508 TC, Utrecht, The Netherlands
| | - Michèlle Bal
- Department of Interdisciplinary Social Science- Social Policy and Public Health, Utrecht University, PO Box 80140, 3508 TC, Utrecht, The Netherlands
| | - Carlijn B M Kamphuis
- Department of Interdisciplinary Social Science- Social Policy and Public Health, Utrecht University, PO Box 80140, 3508 TC, Utrecht, The Netherlands
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29
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Kelly-Irving M, Delpierre C. Framework for understanding health inequalities over the life course: the embodiment dynamic and biological mechanisms of exogenous and endogenous origin. J Epidemiol Community Health 2021; 75:1181-1186. [PMID: 34376565 DOI: 10.1136/jech-2021-216430] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 06/27/2021] [Indexed: 11/04/2022]
Abstract
Understanding how structural, social and psychosocial factors come to affect our health resulting in health inequalities is more relevant now than ever as trends in mortality gaps between rich and poor appear to have widened over the past decades. To move beyond description, we need to hypothesise about how structural and social factors may cause health outcomes. In this paper, we examine the construction of health over the life course through the lens of influential theoretical work. Based on concepts developed by scholars from different disciplines, we propose a novel framework for research on social-to-biological processes which may be important contributors to health inequalities. We define two broad sets of mechanisms that may help understand how socially structured exposures become embodied: mechanisms of exogenous and endogenous origin. We describe the embodiment dynamic framework, its uses and how it may be combined with an intersectional approach to examine how intermeshed oppressions affect social exposures which may be expressed biologically. We explain the usefulness of this framework as a tool for carrying out research and providing scientific evidence to challenge genetic essentialism, often used to dismiss social inequalities in health.
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Affiliation(s)
- Michelle Kelly-Irving
- Center for Epidemiology and Research in POPulation health (CERPOP), Université de Toulouse, Inserm, Université Toulouse III Paul Sabatier, Toulouse, France .,Iferiss-Fed 4241, Université Toulouse III Paul Sabatier, Toulouse, France
| | - Cyrille Delpierre
- Center for Epidemiology and Research in POPulation health (CERPOP), Université de Toulouse, Inserm, Université Toulouse III Paul Sabatier, Toulouse, France
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30
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Mandelblatt JS, Ahles TA, Lippman ME, Isaacs C, Adams-Campbell L, Saykin AJ, Cohen HJ, Carroll J. Applying a Life Course Biological Age Framework to Improving the Care of Individuals With Adult Cancers: Review and Research Recommendations. JAMA Oncol 2021; 7:1692-1699. [PMID: 34351358 PMCID: PMC8602673 DOI: 10.1001/jamaoncol.2021.1160] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance The practice of oncology will increasingly involve the care of a growing population of individuals with midlife and late-life cancers. Managing cancer in these individuals is complex, based on differences in biological age at diagnosis. Biological age is a measure of accumulated life course damage to biological systems, loss of reserve, and vulnerability to functional deterioration and death. Biological age is important because it affects the ability to manage the rigors of cancer therapy, survivors' function, and cancer progression. However, biological age is not always clinically apparent. This review presents a conceptual framework of life course biological aging, summarizes candidate measures, and describes a research agenda to facilitate clinical translation to oncology practice. Observations Midlife and late-life cancers are chronic diseases that may arise from cumulative patterns of biological aging occurring over the life course. Before diagnosis, each new patient was on a distinct course of biological aging related to past exposures, life experiences, genetics, and noncancer chronic disease. Cancer and its treatments may also be associated with biological aging. Several measures of biological age, including p16INK4a, epigenetic age, telomere length, and inflammatory and body composition markers, have been used in oncology research. One or more of these measures may be useful in cancer care, either alone or in combination with clinical history and geriatric assessments. However, further research will be needed before biological age assessment can be recommended in routine practice, including determination of situations in which knowledge about biological age would change treatment, ascertaining whether treatment effects on biological aging are short-lived or persistent, and testing interventions to modify biological age, decrease treatment toxic effects, and maintain functional abilities. Conclusions and Relevance Understanding differences in biological aging could ultimately allow clinicians to better personalize treatment and supportive care, develop tailored survivorship care plans, and prescribe preventive or ameliorative therapies and behaviors informed by aging mechanisms.
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Affiliation(s)
- Jeanne S Mandelblatt
- Department of Oncology, Cancer Prevention and Control Program, Georgetown-Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC.,Department of Medicine, Georgetown University Medical Center, Washington, DC
| | - Tim A Ahles
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Marc E Lippman
- Department of Medicine, Georgetown University Medical Center, Washington, DC.,Department of Oncology, Breast Cancer Program, Georgetown-Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC
| | - Claudine Isaacs
- Department of Medicine, Georgetown University Medical Center, Washington, DC.,Department of Oncology, Breast Cancer Program, Georgetown-Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC
| | - Lucile Adams-Campbell
- Department of Oncology, Cancer Prevention and Control Program, Georgetown-Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC
| | - Andrew J Saykin
- Radiology and Imaging Sciences, Center for Neuroimaging, Department of Radiology and Imaging Sciences, Indiana Alzheimer's Disease Research Center and the Melvin and Bren Simon Cancer Center, Indiana University School of Medicine, Indianapolis
| | - Harvey J Cohen
- Center for the Study of Aging and Human Development, Duke University School of Medicine, Durham, North Carolina
| | - Judith Carroll
- UCLA Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, Jane and Terry Semel Institute for Neuroscience and Human Behavior, Jonsson Comprehensive Cancer Center, and Cousins Center for Psychoneuroimmunology, Los Angeles, California
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Abstract
Modern medicine makes it possible for many people to live with multiple chronic diseases for decades, but this has enormous social, financial, and environmental consequences. Preclinical, epidemiological, and clinical trial data have shown that many of the most common chronic diseases are largely preventable with nutritional and lifestyle interventions that are targeting well-characterized signaling pathways and the symbiotic relationship with our microbiome. Most of the research priorities and spending for health are focused on finding new molecular targets for the development of biotech and pharmaceutical products. Very little is invested in mechanism-based preventive science, medicine, and education. We believe that overly enthusiastic expectations regarding the benefits of pharmacological research for disease treatment have the potential to impact and distort not only medical research and practice but also environmental health and sustainable economic growth. Transitioning from a primarily disease-centered medical system to a balanced preventive and personalized treatment healthcare system is key to reduce social disparities in health and achieve financially sustainable, universal health coverage for all. In this Perspective article, we discuss a range of science-based strategies, policies, and structural reforms to design an entire new disease prevention-centered science, educational, and healthcare system that maximizes both human and environmental health.
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Lemes V, Gaya AR, Sadarangani KP, Aguilar-Farias N, Rodriguez-Rodriguez F, Martins CMDL, Fochesatto C, Cristi-Montero C. Physical Fitness Plays a Crucial Mediator Role in Relationships Among Personal, Social, and Lifestyle Factors With Adolescents' Cognitive Performance in a Structural Equation Model. The Cogni-Action Project. Front Pediatr 2021; 9:656916. [PMID: 34195161 PMCID: PMC8236613 DOI: 10.3389/fped.2021.656916] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 05/19/2021] [Indexed: 12/13/2022] Open
Abstract
Background: The beneficial relationship between physical fitness and cognitive performance is affected and modulated by a wide diversity of factors that seem to be more sensitive during the development stage, particularly during early adolescence. This study aimed to examine the role of physical fitness considering the multivariate association between age, health-related quality of life (HRQOL), school vulnerability index (SVI), body mass index z-score (BMIz), physical activity, and sleep problems with the cognitive performance in boys and girls. Method: Participants were 1,196 adolescents aged 10-14 years (50.7% of boys) from Chile. Three physical fitness components and eight cognitive tasks were measured. BMIz was determined using growth references by age and sex, whereas questionaries were used to assess sleep problems, physical activity, and HRQOL. SVI was established according to the score given by the Chilean Government to educational establishments. We performed a structural equation model (SEM) to test multivariate associations among study' variables by sex. Results: Fitness was positively associated with boys' and girls' cognitive performance (β = 0.23 and β = 0.17; p = 0.001, respectively). Moreover, fitness presented a significant mediator role in the relationships between BMIz, SVI, and physical activity with cognitive performance (indirect effect). Additionally, SVI showed a negative association both direct and indirect effect in all three fitness components and all cognitive tasks, being this relationship stronger in girls than in boys. Conclusion: Our findings suggest that physical fitness and all its components play a crucial mediator role in the associations between several factors associated with adolescents' cognitive performance. Thereby, educational and health strategies should prioritise improving physical fitness through physical activity. They also should address other factors such as school vulnerability, obesity, and the early gender gap in a comprehensive approach boosting cognitive performance among early adolescents. Trial registration: Research Registry (ID: researchregistry5791).
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Affiliation(s)
- Vanilson Lemes
- Projeto Esporte Brasil – PROESP-Br, Escola de Educação Física, Fisioterapia e Dança, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Secretaria de Estado da Educação de Santa Catarina – SED-SC, EEB Gracinda Augusta Machado, Imbituba, Brazil
| | - Anelise R. Gaya
- Projeto Esporte Brasil – PROESP-Br, Escola de Educação Física, Fisioterapia e Dança, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Kabir P. Sadarangani
- Universidad Autónoma de Chile, Providencia, Chile
- Escuela de Kinesiología, Facultad de Salud y Odontología, Universidad Diego Portales, Santiago, Chile
| | - Nicolas Aguilar-Farias
- Department of Physical Education, Sports, and Recreation, Universidad de La Frontera, Temuco, Chile
- UFRO Activate Research Group, Universidad de La Frontera, Temuco, Chile
| | | | - Clarice Maria de Lucena Martins
- Research Centre in Physical Activity, Health, and Leisure - CIAFEL, Porto University, Porto, Portugal
- Federal University of Paraíba, João Pessoa, Brazil
| | - Camila Fochesatto
- Projeto Esporte Brasil – PROESP-Br, Escola de Educação Física, Fisioterapia e Dança, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Carlos Cristi-Montero
- IRyS Group, Physical Education School, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile
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Casanova-Rosado JF, Casanova-Rosado AJ, Minaya-Sánchez M, Casanova-Sarmiento JA, Robles-Minaya JL, Márquez-Rodríguez S, Mora-Acosta M, Islas-Zarazúa R, Márquez-Corona MDL, Ávila-Burgos L, Medina-Solís CE, Maupomé G. Self-Reported Dental Caries by Mexican Elementary and Middle-School Schoolchildren in the Context of Socioeconomic Indicators: A National Ecological Study. CHILDREN (BASEL, SWITZERLAND) 2021; 8:289. [PMID: 33917854 PMCID: PMC8068240 DOI: 10.3390/children8040289] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 04/03/2021] [Accepted: 04/07/2021] [Indexed: 12/20/2022]
Abstract
The objective of the present research was to quantify the association between dental caries self-report and socioeconomic indicators in Mexican children. An ecological study included a self-report of dental caries in schoolchildren enrolled in public elementary and middle schools derived from the National School Health Survey. A total of 73,560 schoolchildren (representing 19,745,366 students) aged 5 to 16 years were included. Socioeconomic variables included were scales depicting physical characteristics of housing, purchasing power, etc. used in national surveys in Mexico to measure deprivation, poverty, and income inequality in official data. Data were analyzed in Stata using Spearman's correlation test. For the most part, no association (p > 0.05) was found between caries self-report, socioeconomic variables, or the Gini index. However, caries self-report in elementary schoolchildren and total (elementary + middle-school) schoolchildren groups was positively correlated (p < 0.05) with two poverty variables: extreme poverty by income (value of personal food purchases per month) and poverty by income (value of personal food and non-food purchases per month). National data for dental caries self-report were associated-at the ecological level-with a few socioeconomic indicators but not with most of the usual and customary indicators used in national surveys in Mexico.
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Affiliation(s)
- Juan Fernando Casanova-Rosado
- School of Dentistry, Autonomous University of Campeche, Campeche 24039, Mexico; (J.F.C.-R.); (A.J.C.-R.); (J.A.C.-S.); (J.L.R.-M.)
| | - Alejandro José Casanova-Rosado
- School of Dentistry, Autonomous University of Campeche, Campeche 24039, Mexico; (J.F.C.-R.); (A.J.C.-R.); (J.A.C.-S.); (J.L.R.-M.)
| | - Mirna Minaya-Sánchez
- School of Dentistry, Autonomous University of Campeche, Campeche 24039, Mexico; (J.F.C.-R.); (A.J.C.-R.); (J.A.C.-S.); (J.L.R.-M.)
| | | | - José Luis Robles-Minaya
- School of Dentistry, Autonomous University of Campeche, Campeche 24039, Mexico; (J.F.C.-R.); (A.J.C.-R.); (J.A.C.-S.); (J.L.R.-M.)
| | - Sonia Márquez-Rodríguez
- Academic Area of Dentistry, Health Sciences Institute, Autonomous University of Hidalgo State, Pachuca 42160, Mexico; (S.M.-R.); (M.M.-A.); (R.I.-Z.); (M.d.L.M.-C.)
| | - Mariana Mora-Acosta
- Academic Area of Dentistry, Health Sciences Institute, Autonomous University of Hidalgo State, Pachuca 42160, Mexico; (S.M.-R.); (M.M.-A.); (R.I.-Z.); (M.d.L.M.-C.)
| | - Rosalina Islas-Zarazúa
- Academic Area of Dentistry, Health Sciences Institute, Autonomous University of Hidalgo State, Pachuca 42160, Mexico; (S.M.-R.); (M.M.-A.); (R.I.-Z.); (M.d.L.M.-C.)
| | - María de Lourdes Márquez-Corona
- Academic Area of Dentistry, Health Sciences Institute, Autonomous University of Hidalgo State, Pachuca 42160, Mexico; (S.M.-R.); (M.M.-A.); (R.I.-Z.); (M.d.L.M.-C.)
| | - Leticia Ávila-Burgos
- Health Systems Research Center, the National Institute of Public Health, Cuernavaca 62100, Mexico;
| | - Carlo Eduardo Medina-Solís
- Academic Area of Dentistry, Health Sciences Institute, Autonomous University of Hidalgo State, Pachuca 42160, Mexico; (S.M.-R.); (M.M.-A.); (R.I.-Z.); (M.d.L.M.-C.)
- Advanced Studies and Research Center in Dentistry “Keisaburo Miyata”, School of Dentistry, Autonomous University of State of Mexico, Toluca 50000, Mexico
| | - Gerardo Maupomé
- Richard M. Fairbanks School of Public Health, Indiana University/Purdue University, Indianapolis, IN 46202, USA;
- Indiana University Network Science Institute, Bloomington, IN 47408, USA
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Kovanda A, Zimani AN, Peterlin B. How to design a national genomic project-a systematic review of active projects. Hum Genomics 2021; 15:20. [PMID: 33761998 PMCID: PMC7988644 DOI: 10.1186/s40246-021-00315-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 02/23/2021] [Indexed: 01/18/2023] Open
Abstract
An increasing number of countries are investing efforts to exploit the human genome, in order to improve genetic diagnostics and to pave the way for the integration of precision medicine into health systems. The expected benefits include improved understanding of normal and pathological genomic variation, shorter time-to-diagnosis, cost-effective diagnostics, targeted prevention and treatment, and research advances.We review the 41 currently active individual national projects concerning their aims and scope, the number and age structure of included subjects, funding, data sharing goals and methods, and linkage with biobanks, medical data, and non-medical data (exposome). The main aims of ongoing projects were to determine normal genomic variation (90%), determine pathological genomic variation (rare disease, complex diseases, cancer, etc.) (71%), improve infrastructure (59%), and enable personalized medicine (37%). Numbers of subjects to be sequenced ranges substantially, from a hundred to over a million, representing in some cases a significant portion of the population. Approximately half of the projects report public funding, with the rest having various mixed or private funding arrangements. 90% of projects report data sharing (public, academic, and/or commercial with various levels of access) and plan on linking genomic data and medical data (78%), existing biobanks (44%), and/or non-medical data (24%) as the basis for enabling personal/precision medicine in the future.Our results show substantial diversity in the analysed categories of 41 ongoing national projects. The overview of current designs will hopefully inform national initiatives in designing new genomic projects and contribute to standardisation and international collaboration.
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Affiliation(s)
- Anja Kovanda
- Clinical Institute of Genomic Medicine, University Medical Centre Ljubljana, Slajmerjeva 4, Ljubljana, Slovenia
| | - Ana Nyasha Zimani
- Clinical Institute of Genomic Medicine, University Medical Centre Ljubljana, Slajmerjeva 4, Ljubljana, Slovenia
| | - Borut Peterlin
- Clinical Institute of Genomic Medicine, University Medical Centre Ljubljana, Slajmerjeva 4, Ljubljana, Slovenia.
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Freni-Sterrantino A, Salerno V. A Plea for the Need to Investigate the Health Effects of Gig-Economy. Front Public Health 2021; 9:638767. [PMID: 33634072 PMCID: PMC7900166 DOI: 10.3389/fpubh.2021.638767] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 01/18/2021] [Indexed: 01/04/2023] Open
Affiliation(s)
- Anna Freni-Sterrantino
- Department of Epidemiology and Biostatistics, Medical Research Council Centre for Environment and Health, Imperial College London, London, United Kingdom
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36
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Ghiara V. Commentary: Special Report: The Biology of Inequalities in Health: The Lifepath Consortium. Front Public Health 2020; 8:504530. [PMID: 33194935 PMCID: PMC7658384 DOI: 10.3389/fpubh.2020.504530] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Accepted: 09/28/2020] [Indexed: 11/13/2022] Open
Affiliation(s)
- Virginia Ghiara
- Department of Philosophy, University of Kent, Canterbury, United Kingdom
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37
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Maurel M, Castagné R, Berger E, Bochud M, Chadeau-Hyam M, Fraga S, Gandini M, Hutri-Kähönen N, Jalkanen S, Kivimäki M, Marmot M, McCrory C, Preisig M, Raitakari O, Ricceri F, Salmi M, Steptoe A, Vineis P, Delpierre C, Kelly-Irving M. Patterning of educational attainment across inflammatory markers: Findings from a multi-cohort study. Brain Behav Immun 2020; 90:303-310. [PMID: 32919037 PMCID: PMC8140486 DOI: 10.1016/j.bbi.2020.09.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 08/21/2020] [Accepted: 09/04/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Evidence suggests that the inflammatory reaction, an adaptive response triggered by a variety of harmful stimuli and conditions involved in the risk and development of many chronic diseases, is a potential pathway through which the socioeconomic environment is biologically embedded. Difficulty in interpreting the role of the inflammatory system in the embodiment dynamic arises because of heterogeneity across studies that use a limited but varied number of inflammatory markers. There is no consensus in the literature as to which inflammatory markers beyond the C-reactive protein and to a lesser extent interleukin 6 are related to the social environment. Accordingly, we aimed to investigate the association between educational attainment, and several markers of inflammation - C-reactive protein, fibrinogen, interleukin 6, interleukin 1β and tumor necrosis factor α- in 6 European cohort studies. METHODS Up to 17,470 participants from six European cohort studies with data on educational attainment, health behaviors and lifestyle factors, and at least two different inflammatory markers. Four sub-datasets were drawn with varying numbers of participants to allow pairwise comparison of the social patterning of C-reactive protein and any other inflammatory markers. To evaluate within each sub-dataset the importance of the context and cohort specificities, linear regression-based analyses were performed separately for each cohort and combined in a random effect meta-analysis to determine the relationship between educational attainment and inflammation. RESULTS We found that the magnitude of the relationship between educational attainment and five inflammatory biomarkers (C-reactive protein, fibrinogen, interleukin 6 and 1β and tumor necrosis factor α) was variable. By far the most socially patterned biomarker was C-reactive protein, followed by fibrinogen and to lesser extent interleukin 6, where a low educational attainment was associated with higher inflammation even after adjusting for health behaviours and body mass index. No association was found with interleukin 1β and tumor necrosis factor α. CONCLUSIONS Our study suggests different educational patterning of inflammatory biomarkers. Further large-scale research is needed to explore social differences in the inflammatory cascade in greater detail and the extent to which these differences contribute to social inequalities in health.
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Affiliation(s)
- Marine Maurel
- UMR1027, Université de Toulouse, UPS, Inserm, Toulouse, France
| | | | - Eloïse Berger
- UMR1027, Université de Toulouse, UPS, Inserm, Toulouse, France
| | - Murielle Bochud
- Psychiatric Epidemiology and Psychopathology Research Center, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne 1004, Switzerland
| | - Marc Chadeau-Hyam
- MRC-PHE Centre for Environment and Health, School of Public Health, Department of Epidemiology and Biostatistics, Imperial College London, London W2 1PG, UK
| | - Silvia Fraga
- EPIUnit-Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal
| | - Martina Gandini
- Epidemiology Unit, ASL TO3 Piedmont Region, Grugliasco 10095, Italy; Environmental Epidemiological Unit, Regional Environmental Protection Agency, Piedmont Region, Via Pio VII 9, 10135 Turin, Italy
| | - Nina Hutri-Kähönen
- Department of Pediatrics, Tampere University Hospital and Faculty of Medicine and Life Sciences, Tampere University, Tampere, Finland
| | - Sirpa Jalkanen
- MediCity Research Laboratory, University of Turku, Turku, Finland; Institute of Biomedicine, University of Turku, Turku, Finland
| | - Mika Kivimäki
- Department of Epidemiology and Public Health, University College London, London WC1E 6BT, UK; Clinicum, Faculty of Medicine, University of Helsinki, P. O. Box 20, Helsinki FI-00014, Finland
| | - Michael Marmot
- UCL Institute of Health Equity, Department of Epidemiology and Public Health, UCL, 1-19 Torrington Place, WC1E 6BT, London
| | - Cathal McCrory
- Department of Medical Gerontology, Trinity College Dublin, Ireland
| | - Martin Preisig
- Psychiatric Epidemiology and Psychopathology Research Center, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne 1004, Switzerland
| | - Olli Raitakari
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland; Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
| | - Fulvio Ricceri
- Epidemiology Unit, ASL TO3 Piedmont Region, Grugliasco 10095, Italy; Department of Clinical and Biological Sciences, University of Turin, Italy
| | - Marko Salmi
- MediCity Research Laboratory, University of Turku, Turku, Finland; Institute of Biomedicine, University of Turku, Turku, Finland
| | - Andrew Steptoe
- Department of Epidemiology and Public Health, University College London, London WC1E 6BT, UK
| | - Paolo Vineis
- MRC-PHE Centre for Environment and Health, School of Public Health, Department of Epidemiology and Biostatistics, Imperial College London, London W2 1PG, UK; Italian Institute for Genomic Medicine, Torino, Italy
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MacGuire FAS. Reducing Health Inequalities in Aging Through Policy Frameworks and Interventions. Front Public Health 2020; 8:315. [PMID: 32850574 PMCID: PMC7411218 DOI: 10.3389/fpubh.2020.00315] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 06/09/2020] [Indexed: 12/11/2022] Open
Abstract
Lifepath, a European Commission Horizon 2020 programme of research adopted a life course approach to understanding the impacts of socioeconomic differences on healthy aging and considered the relative importance of lifetime effects by comparing studies on childhood and adult risks. A key component of the programme was the identification of policy relevant results and messages. Longitudinal European cohorts of over 1.7 million individuals from 48 independent cohort studies were harmonized and followed for the key outcomes of mortality and functional decline. Biological markers, allostatic load, and DNA methylation were also examined to help unravel the impact of socioeconomic factors including education, occupation, or income on aging. It is well-recognized that socioeconomic position affects behaviors such as smoking, high alcohol consumption, low physical activity, and a diet low in fruit and vegetables. Lifepath indicated that socioeconomic status is an independent risk factor for death and disease but that it also helps drive the uptake of these well-recognized risk behaviors. The evidence from Lifepath points to a suite of possible policies, some universal, some targeted but it was not possible to assess specific interventions, other than conditional cash transfers, or to explore how interventions might be effective in reducing health inequalities in aging. Nevertheless, it was clear that the timing of interventions is important as the consequences of early interventions may span the whole life course. These influences have important implications for policy making, since appropriate policies can reverse the embodiment of socioeconomic disadvantage, thus reducing health inequalities and resulting in healthier aging. Applying principles of proportional universalism as one approach to reducing inequalities should be considered.
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Affiliation(s)
- Frances A S MacGuire
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
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