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Xu F, Earp JE, Delmonico MJ, Lofgren IE, Riebe D. A cross-sectional study of the relationship between physical activity, diet quality, and high-sensitivity C-reactive protein in US adults. Nutr Metab Cardiovasc Dis 2024; 34:1226-1234. [PMID: 38418349 DOI: 10.1016/j.numecd.2023.12.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 11/27/2023] [Accepted: 12/24/2023] [Indexed: 03/01/2024]
Abstract
BACKGROUND AND AIMS High-sensitivity C-reactive protein (hs-CRP) is associated with many diseases, especially cardiovascular disease (CVD). Research into the independent and integrated relationships of physical activity and diet quality with hs-CRP across sex-specific cohorts is lacking. METHODS AND RESULTS National Health and Nutrition Examination Survey data (2015-2018) was used to examine the relationship between physical activity and diet quality with hs-CRP and hs-CRP classified CVD risk using multiple multinormal logistic regression adjusted for covariates including demographics. Physical activity was measured using a self-reported survey and further categorized to those who met (MPAR) or did not meet (NPAR) national recommendations. Diet quality was measured using the Healthy Eating Index-2015, and further categorized to higher (HDQ) and lower (LDQ) diet quality. hs-CRP was also categorized as low, average, and high CVD risk using established cut-points. Physical activity was inversely related to hs-CRP in males (p < 0.001) whereas diet quality was inversely related to hs-CRP in females (p = 0.031). Compared to those with NPAR and LDQ, the hs-CRP for males with NPAR and HDQ and females with MPAR and HDQ was 1.18 mg/L and 0.75 mg/L lower respectively. Although, diet quality was inversely associated with high CVD risk in both sexes (p < 0.05), the lowest proportion of high and average CVD risk was observed in males and females with MPAR and HDQ. CONCLUSION Physical activity and diet-quality lowered CVD risk regardless of sex. However, the independent effects of physical activity and diet quality on hs-CPR differs between sexes.
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Affiliation(s)
- Furong Xu
- College of Education, University of Rhode Island, 142 Flagg Road, Kingston, RI 02881, United States.
| | - Jacob E Earp
- Department of Kinesiology, University of Connecticut, Storrs, CT 06269, United States
| | - Matthew J Delmonico
- Department of Kinesiology, University of Rhode Island, Independent Square, Kingston, RI 02881, United States
| | - Ingrid E Lofgren
- Department of Nutrition, University of Rhode Island, Fogarty Hall, Kingston, RI 02881, United States
| | - Deborah Riebe
- Department of Kinesiology, University of Rhode Island, Independent Square, Kingston, RI 02881, United States
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Xu F, Earp JE, Adami A, Blissmer BJ, Riebe D, Greene GW. Sex and race/ethnicity specific reference predictive equations for abdominal adiposity indices using anthropometry in US adults. Nutr Metab Cardiovasc Dis 2023; 33:956-966. [PMID: 36958968 DOI: 10.1016/j.numecd.2023.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 02/27/2023] [Accepted: 03/01/2023] [Indexed: 03/07/2023]
Abstract
BACKGROUND AND AIMS Abdominal adiposity indices have stronger associations with cardiometabolic risk factors compared to anthropometric measures but are rarely used in large scale studies due to the cost and efficiency. The aim of this study is to establish sex and race/ethnicity specific reference equations using anthropometric measures. METHODS AND RESULTS A secondary data analysis (n = 6589) of healthy adults was conducted using data from National Health and Nutrition Examination Survey 2011-2018. Variables included in the analyses were anthropometric measures (height; weight; waist circumference, WC) and abdominal adiposity indices (android percent fat; android to gynoid ratio, A/G ratio; visceral adipose tissue area, VATA; visceral to subcutaneous adipose area ratio, VSR). Multivariable prediction models were developed using quantile regression. Bland-Altman was used for external validation of prediction models. Reference equations to estimate android percent fat, A/G ratio, VATA and VSR from anthropometric measurements were developed using a randomly selected subsample of 4613. These reference equations for four abdominal adiposity indices were then cross-validated in the remaining subsample of 1976. The measured and predicted android percent fat, A/G ratio, VATA and VSR were not statistically different (p > 0.05) except for the A/G ratio in Asian males and VSR in White females. The results of Bland-Altman further revealed that ≥93% of predicted abdominal adiposity indices fell within the limits of agreement (±1.96 standard deviation). CONCLUSION The sex and race/ethnicity specific reference equations for abdominal adiposity indices established using anthropometrics in the present study have strong predictive ability in US healthy adults.
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Affiliation(s)
- Furong Xu
- School of Education, University of Rhode Island, 142 Flagg Road, Kingston, RI 02881, United States.
| | - Jacob E Earp
- Department of Kinesiology, University of Connecticut, Storrs, CT 06269, United States
| | - Alessandra Adami
- Department of Kinesiology, University of Rhode Island, Independent Square, Kingston, RI 02881, United States
| | - Bryan J Blissmer
- Department of Kinesiology, University of Rhode Island, Independent Square, Kingston, RI 02881, United States
| | - Deborah Riebe
- Department of Kinesiology, University of Rhode Island, Independent Square, Kingston, RI 02881, United States
| | - Geoffrey W Greene
- Department of Nutrition and Food Sciences, University of Rhode Island, Fogarty Hall, Kingston, RI 02881, United States
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Liu CA, Liu T, Ge YZ, Song MM, Ruan GT, Lin SQ, Xie HL, Shi JY, Zheng X, Chen Y, Shen L, Deng L, Shi HP. Muscle distribution in relation to all-cause and cause-specific mortality in young and middle-aged adults. J Transl Med 2023; 21:154. [PMID: 36841788 PMCID: PMC9960213 DOI: 10.1186/s12967-023-04008-7] [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: 01/13/2023] [Accepted: 02/16/2023] [Indexed: 02/27/2023] Open
Abstract
BACKGROUND The relationship between muscle and prognosis, especially that between muscle distribution across different body parts, and the related prognosis is not well established. OBJECTIVE To investigate the relationship between muscle distribution and all-cause and cause-specific mortality and their potential modifiers. DESIGN Longitudinal cohort study. C-index, IDI, and NRI were used to determine the best indicator of prognosis. COX regression analysis was performed to explore the relationship between variables and outcomes. Interaction and subgroup analyses were applied to identify the potential modifiers. PARTICIPANTS A total of 5052 participants (weighted: 124,841,420) extracted from the NHANES 2003-2006 of median age 45 years and constituting 50.3% men were assessed. For validation, we included 3040 patients from the INSCOC cohort in China. MAIN MEASURES Muscle mass and distribution. KEY RESULTS: COX regression analysis revealed that upper limbs (HR = 0.41, 95% CI 0.33-0.51), lower limbs (HR = 0.54, 95% CI 0.47-0.64), trunk (HR = 0.71, 95% CI, 0.59-0.85), gynoid (HR = 0.47, 95% CI 0.38-0.58), and total lean mass (HR = 0.55, 95% CI 0.45-0.66) were all associated with the better survival of participants (P trend < 0.001). The changes in the lean mass ratio of the upper and lower limbs and the lean mass ratio of the android and gynoid attenuated the protective effect of lean mass. Age and sex acted as potential modifiers, and the relationship between lean mass and the prognosis was more significant in men and middle-aged participants when compared to that in other age groups. Sensitive analyses depicted that despite lean mass having a long-term impact on prognosis (15 years), it has a more substantial effect on near-term survival (5 years). CONCLUSION Muscle mass and its distribution affect the prognosis with a more significant impact on the near-term than that on the long-term prognosis. Age and sex acted as vital modifiers.
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Affiliation(s)
- Chen-An Liu
- grid.24696.3f0000 0004 0369 153XDepartment of Gastrointestinal Surgery, Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038 China ,grid.24696.3f0000 0004 0369 153XNational Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, 100053 China ,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038 China ,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038 China
| | - Tong Liu
- grid.24696.3f0000 0004 0369 153XDepartment of Gastrointestinal Surgery, Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038 China ,grid.24696.3f0000 0004 0369 153XNational Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, 100053 China ,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038 China ,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038 China
| | - Yi-Zhong Ge
- grid.24696.3f0000 0004 0369 153XDepartment of Gastrointestinal Surgery, Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038 China ,grid.24696.3f0000 0004 0369 153XNational Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, 100053 China ,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038 China ,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038 China
| | - Meng-Meng Song
- grid.24696.3f0000 0004 0369 153XDepartment of Gastrointestinal Surgery, Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038 China ,grid.24696.3f0000 0004 0369 153XNational Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, 100053 China ,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038 China ,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038 China
| | - Guo-Tian Ruan
- grid.24696.3f0000 0004 0369 153XDepartment of Gastrointestinal Surgery, Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038 China ,grid.24696.3f0000 0004 0369 153XNational Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, 100053 China ,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038 China ,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038 China
| | - Shi-Qi Lin
- grid.24696.3f0000 0004 0369 153XDepartment of Gastrointestinal Surgery, Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038 China ,grid.24696.3f0000 0004 0369 153XNational Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, 100053 China ,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038 China ,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038 China
| | - Hai-Lun Xie
- grid.24696.3f0000 0004 0369 153XDepartment of Gastrointestinal Surgery, Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038 China ,grid.24696.3f0000 0004 0369 153XNational Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, 100053 China ,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038 China ,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038 China
| | - Jin-Yu Shi
- grid.24696.3f0000 0004 0369 153XDepartment of Gastrointestinal Surgery, Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038 China ,grid.24696.3f0000 0004 0369 153XNational Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, 100053 China ,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038 China ,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038 China
| | - Xin Zheng
- grid.24696.3f0000 0004 0369 153XDepartment of Gastrointestinal Surgery, Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038 China ,grid.24696.3f0000 0004 0369 153XNational Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, 100053 China ,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038 China ,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038 China
| | - Yue Chen
- grid.24696.3f0000 0004 0369 153XDepartment of Gastrointestinal Surgery, Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038 China ,grid.24696.3f0000 0004 0369 153XNational Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, 100053 China ,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038 China ,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038 China
| | - Liuyi Shen
- grid.263452.40000 0004 1798 4018Shanxi Medical University, Taiyuan, Shanxi 030001 China
| | - Li Deng
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038 China ,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038 China
| | - Han-Ping Shi
- Department of Gastrointestinal Surgery, Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China. .,National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China. .,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China. .,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, China.
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Xu F, Earp JE, Adami A, Lofgren IE, Delmonico MJ, Greene GW, Riebe D. The Sex and Race/Ethnicity-Specific Relationships of Abdominal Fat Distribution and Anthropometric Indices in US Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15521. [PMID: 36497594 PMCID: PMC9736224 DOI: 10.3390/ijerph192315521] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 11/18/2022] [Accepted: 11/19/2022] [Indexed: 06/17/2023]
Abstract
The purpose of this study was to examine demographic-specific relationships between direct abdominal fat measures and anthropometric indices. A cross-sectional study was conducted utilizing abdominal fat measures (visceral fat area, VFA; visceral to subcutaneous adipose area ratio, VSR) and anthropometrics (body mass index, BMI; waist circumference, WC) data from the 2011-2018 National Health and Nutrition Examination Survey. Linear or polynomial linear regression models were used to examine the relationships of abdominal fat measures to anthropometrics with adjustment for demographics. The results revealed that while VFA was linearly related to BMI and WC across all demographics (p < 0.001), the relationships between VSR and both BMI and WC were concave in men and convex in women. The relationships between VFA, VSR, and BMI, WC varied by sex and race/ethnicity. In conclusion, increasing BMI and WC were linearly associated with increased VFA, but their relationships with VSR were nonlinear and differed by sex.
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Affiliation(s)
- Furong Xu
- School of Education, University of Rhode Island, 142 Flagg Road, Kingston, RI 02881, USA
| | - Jacob E. Earp
- Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USA
| | - Alessandra Adami
- Department of Kinesiology, University of Rhode Island, Independence Square, Kingston, RI 02881, USA
| | - Ingrid E. Lofgren
- Department of Nutrition and Food Sciences, University of Rhode Island, Fogarty Hall, Kingston, RI 02881, USA
| | - Matthew J. Delmonico
- Department of Kinesiology, University of Rhode Island, Independence Square, Kingston, RI 02881, USA
| | - Geoffrey W. Greene
- Department of Nutrition and Food Sciences, University of Rhode Island, Fogarty Hall, Kingston, RI 02881, USA
| | - Deborah Riebe
- Department of Kinesiology, University of Rhode Island, Independence Square, Kingston, RI 02881, USA
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Xu F, Earp JE, Blissmer BJ, Lofgren IE, Delmonico MJ, Greene GW. The Demographic Specific Abdominal Fat Composition and Distribution Trends in US Adults from 2011 to 2018. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12103. [PMID: 36231408 PMCID: PMC9565041 DOI: 10.3390/ijerph191912103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 09/21/2022] [Accepted: 09/22/2022] [Indexed: 06/16/2023]
Abstract
Despite the rising awareness of abdominal adiposity associated health problems and demographic health disparities, research is lacking about abdominal fat trends using a national representative sample of US adults. Our purpose was to examine national demographic specific abdominal fat composition and distribution trends from 2011 to 2018. This trend analysis was using National Health and Nutrition Examination Survey data (n = 13,163). Visceral adipose percent (VAT%), visceral adipose tissue area (VAA) and visceral to subcutaneous adipose area ratio (VSR) were utilized in data analyses. Multiple polynomial linear regression was utilized with adjustment for confounding variables. Our findings revealed that VAT%, VAA and VSR trends were concave among all demographic groups. The VAT%, VAA and/or VSR changes were observed in most demographic groups (p < 0.05) except younger, White and Black respondents. The pattern was consistent with biennial increases up to 2014 or 2016 followed by decreases in 2017-2018. There were demographic disparities, with middle-aged respondents and Hispanics having the most evident VAT%, VSR and/or VAA changes biennially when compared to their counterparts (p < 0.05). In conclusion, abdominal fat composition and distribution increased before 2014 or 2016 but decreased afterwards with variations by age and/or race/ethnicity. Further research is needed to explore the possible causes of abdominal fat changes overtime.
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Affiliation(s)
- Furong Xu
- School of Education, University of Rhode Island, Kingston, RI 02881, USA
| | - Jacob E. Earp
- Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USA
| | - Bryan J. Blissmer
- Department of Kinesiology, University of Rhode Island, Kingston, RI 02881, USA
| | - Ingrid E. Lofgren
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI 02881, USA
| | | | - Geoffrey W. Greene
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI 02881, USA
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