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Kou L, Sun J, Wu P, Cheng Z, Zhou P, Li N, Cheng L, Xu P, Xue Y, Tian J, Chen W. Associations of dietary pattern, insulin resistance and risk of developing metabolic syndrome among Chinese population. PLoS One 2024; 19:e0308090. [PMID: 39106225 DOI: 10.1371/journal.pone.0308090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 07/17/2024] [Indexed: 08/09/2024] Open
Abstract
Evidence regarding the role of dietary patterns in metabolic syndrome (MetS) is limited. The mechanistic links between dietary patterns, insulin resistance, and MetS are not fully understood. This study aimed to evaluate the associations between dietary patterns and the risk of MetS in a Chinese population using a longitudinal design. Data from the China Health and Nutrition Survey, a nationally representative survey, were analyzed. MetS cases were identified based on biomarker data collected in 2009. Factor analysis was employed to identify dietary patterns, while logistic regression models were utilized to examine the association between dietary patterns and MetS. Mediation models were applied to assess multiple mediation effects. Two dietary patterns were revealed by factor analysis. Participants in the higher quartiles of the traditional Chinese dietary pattern had lower odds of MetS than those in the lowest quartile (Q1) (OR = 0.58, 95%CI: 0.48, 0.69 for Q4; OR = 0.75, 95%CI: 0.63, 0.89 for Q3). Conversely, participants in the higher quartiles of the modern Chinese dietary pattern had higher odds of MetS compared to those in the lowest quartile (Q1) (OR = 1.40, 95%CI: 1.17, 1.68 for Q4; OR = 1.27, 95%CI: 1.06, 1.52 for Q3). Significant associations between dietary patterns and MetS were mediated by insulin resistance. Therefore, dietary patterns in Chinese adults are associated with MetS, and these associations appear to be mediated through insulin resistance. These findings underscore the critical role of dietary patterns in the development of MetS and establish a foundation for culturally tailored dietary interventions aimed at reducing rates the prevalence of MetS among Chinese adults.
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Affiliation(s)
- Liyong Kou
- Department of General Practice, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, People's Republic of China
| | - Jing Sun
- Department of Nutrition, Functional Food Clinical Evaluation Center, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, People's Republic of China
| | - Ping Wu
- Department of Nutrition, Functional Food Clinical Evaluation Center, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, People's Republic of China
| | - Zhou Cheng
- Department of General Practice, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, People's Republic of China
| | - Ping Zhou
- Department of General Practice, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, People's Republic of China
| | - Nana Li
- Department of General Practice, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, People's Republic of China
| | - Liang Cheng
- Department of General Practice, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, People's Republic of China
| | - Pengfei Xu
- Department of General Practice, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, People's Republic of China
| | - Yunzhuo Xue
- Department of General Practice, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, People's Republic of China
| | - Jiamin Tian
- Department of General Practice, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, People's Republic of China
| | - Wei Chen
- Department of General Practice, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, People's Republic of China
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Bermúdez-Millán A, Feinn R, Hahn C, Jui SA, Berthold SM, Buckley T, Buxton O, Kong S, Kuoch T, Scully M, Wagner J. SNAP participation moderates the association between household food insecurity and HbA1c among Cambodian Americans with depression. ETHNICITY & HEALTH 2022; 27:1718-1731. [PMID: 34121523 PMCID: PMC8666460 DOI: 10.1080/13557858.2021.1939272] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 05/28/2021] [Indexed: 05/31/2023]
Abstract
OBJECTIVES We tested whether participation in the Supplemental Nutrition Assistance Program (SNAP) moderated the relation between household food insecurity and HbA1c among Cambodian Americans with depression enrolled in a diabetes prevention trial. METHODS Community health workers assessed household food insecurity and SNAP participation. HbA1c was ascertained using direct enzymatic assay. RESULTS Among the n = 189 respondents, 19% were food insecure, 41% received SNAP benefits, and mean HbA1c = 5.5%. There was a significant interaction between SNAP and food insecurity. HbA1c was highest among participants without SNAP who were food insecure. Simple effects analysis revealed a significant difference within the no SNAP group [Mean (SD): Secure = 5.38 (0.38), Insecure = 5.78 (0.36)] and no difference within the SNAP group [Secure = 5.61(0.44), Insecure = 5.61(0.55)]. Differences remained significant after controlling for demographic, socioeconomic, and clinical indicators. CONCLUSIONS SNAP may protect against the deleterious association between household food insecurity and HbA1c.
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Affiliation(s)
- Angela Bermúdez-Millán
- Department of Public Health Sciences, School of Medicine, UConn Health, Program in Applied Public Health Sciences, Farmington, CT, USA
| | - Richard Feinn
- School of Medicine, Quinnipiac University, Hamden, CT, USA
| | - Chelsey Hahn
- Department of Public Health Sciences, School of Medicine, UConn Health, Program in Applied Public Health Sciences, Farmington, CT, USA
| | - Shanjida A Jui
- Department of Public Health Sciences, School of Medicine, UConn Health, Program in Applied Public Health Sciences, Farmington, CT, USA
| | - S Megan Berthold
- University of Connecticut, School of Social Work, Hartford, CT, USA
| | - Thomas Buckley
- Department of Pharmacy Practice, University of Connecticut School of Pharmacy, Storrs, CT, USA
| | - Orfeu Buxton
- Elizabeth Fenton Susman Professor of Biobehavioral Health, Pennsylvania State University, University Park, PA, USA
| | - Sengly Kong
- Khmer Health Advocates, West Hartford, CT, USA
| | | | - Mary Scully
- Khmer Health Advocates, West Hartford, CT, USA
| | - Julie Wagner
- Department of Behavioral Sciences and Community Health, School of Dental Medicine, UConn Health, Farmington, CT, USA
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Dyal RN, Deschamps BA, McGraw SM, Jayne JM, Karl JP, Cole RE. Healthy Eating Score-7 as a Measure of Diet Quality in a Military Population. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2022; 54:455-464. [PMID: 35000832 DOI: 10.1016/j.jneb.2021.09.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 09/24/2021] [Accepted: 09/29/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE Identify potential revisions to the Healthy Eating Score (HES-5) that improve associations with the Healthy Eating Index (HEI) -2015 total and component scores. METHODS Pearson r correlations were determined from soldiers' (n = 433) survey data, including the HES, proposed additional questions, and the Block Food Frequency Questionnaire. RESULTS Adding sugar-sweetened beverages and energy drink questions (HES-7) strengthened the HES and HEI-2015 correlation (HES-5; r = 0.42, n = 433, r2 = 0.18, P < 0.001) (HES-7; r = 0.52, r2 = 0.27, P < 0.001). The HES components and Block Food Frequency Questionnaire consumption correlations were as follows: quantity of fruit (r = 0.37, r2 = 0.14, P < 0.001), vegetables (r = 0.41, r2 = 0.17, P < 0.001), whole grains (r = 0.35, r2 = 0.12 P < 0.001), dairy (r = 0.34, r2 = 0.12, P < 0.001), fish (r = 0.31, r2 = 0.10, P < 0.001), and energy drink (r = 0.59, r2 = 0.35, P < 0.001). CONCLUSIONS AND IMPLICATIONS HES-7 had the strongest correlation with HEI-2015. Future studies can explore if including consumption quantity in the HES improves its representation of diet quality.
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Affiliation(s)
- Rachel N Dyal
- Madigan Army Medical Center, Nutrition Care Division, Joint Base Lewis McChord, WA.
| | - Bethany A Deschamps
- Madigan Army Medical Center, Nutrition Care Division, Joint Base Lewis McChord, WA
| | - Susan M McGraw
- US Army Research Institute of Environmental Medicine, Military Nutrition Division, Natick, MA
| | - Julianna M Jayne
- US Army Research Institute of Environmental Medicine, Military Nutrition Division, Natick, MA
| | - J Philip Karl
- US Army Research Institute of Environmental Medicine, Military Nutrition Division, Natick, MA
| | - Renee E Cole
- Medical Center of Excellence, Graduate Program in Nutrition, Joint Base San Antonio, Fort Sam Houston, TX
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Age and Sex-Specific Associations in Health Risk Factors for Chronic Disease: Evidence from the Atlantic Partnership for Tomorrow's Health (PATH) Cohort. Can J Aging 2021; 41:164-175. [PMID: 34266509 DOI: 10.1017/s0714980821000179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
The objective of this study was to discern health risk factors for chronic disease by age and sex in a Canadian cohort. Participants of the Atlantic Partnership for Tomorrow's Health (PATH) cohort with health risk factor data (physical activity, smoking, alcohol consumption, diet, body mass index [BMI]) were included (n = 16,165). Multivariable logistic regression models were used to evaluate the relationship among health risk factors, age, and sex. Regression analysis revealed that the odds of engaging in high levels of physical activity and having a BMI ≥ 25 was lower for females than males across all age groups, whereas the odds of abdominal obesity was substantially higher for females of all ages than for males. The odds of habitually consuming alcohol was lower for females of all ages than for males, and the odds of being a former/current smoker was lower for older (57-74 years of age) females than for males. The odds of consuming five or more servings of fruit and vegetables per day was higher for females of all ages than for males. There are evident differences in health risk factors for males and for females, as well as across age groups, and public health efforts need to account for the role played by sex and age in addressing chronic disease burden in Canadian adults.
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Wabo TMC, Nkondjock VRN, Onwuka JU, Sun C, Han T, Sira J. Association of fourteen years diet quality trajectories and type 2 diabetes mellitus with related biomarkers. Aging (Albany NY) 2021; 13:10112-10127. [PMID: 33819180 PMCID: PMC8064195 DOI: 10.18632/aging.202771] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Accepted: 12/23/2020] [Indexed: 11/25/2022]
Abstract
Diet quality fluctuates throughout one’s adulthood, yet it remains unclear how long-term diet quality changes are related to type 2 diabetes mellitus (T2DM) and its biomarkers. We aimed to examine the association of long-term diet quality with T2DM and its biomarkers. Diet quality was assessed by the revised DBI-07, in which diet quality distance levels (DQD) represented the overall diet quality. Participants were clustered into classes sharing similar DQD levels using latent class mixed model. We used Cox regression and random effect linear regression to assess DQD trajectories’ association with T2DM and its biomarkers. Three DQD trajectories were derived: moderate to gradual decrease, high to moderate, high stable DQD level representing 2.14%, 6.18% and, 91.68% of the population. Compared to class 1, class 2 and 3 were associated with an increased risk of T2DM [HR=4.40; 95%CI: 2.02-9.59]; [HR=3.68; 95% CI: 2.11-6.43]. When class 3 was used as a reference, class 1 was also associated with an increased risk of TDM [HR=2.71; 95%CI: 1.55-4.73]. Our findings suggest that a long-term unhealthy diet is associated with an increased risk of T2DM. Gradually reducing DQD level may not make a difference, which establishes the importance of promoting healthy eating habits at early adulthood.
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Affiliation(s)
- Therese Martin Cheteu Wabo
- Department of Nutrition and Food Hygiene, Harbin Medical University, Harbin 150081, China.,Department of Biomedical Sciences, Faculty of Sciences, University of Ngaoundere, Ngaoundere, Cameroon
| | | | - Justina Ucheojor Onwuka
- Department of Epidemiology, Public Health College, Harbin Medical University, Harbin 150081, China
| | - Changhao Sun
- Department of Nutrition and Food Hygiene, Harbin Medical University, Harbin 150081, China
| | - Tianshu Han
- Department of Nutrition and Food Hygiene, Harbin Medical University, Harbin 150081, China
| | - Jackson Sira
- Department of Biomedical Sciences, Faculty of Sciences, University of Ngaoundere, Ngaoundere, Cameroon.,Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin 150081, China
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Diet Quality and Neighborhood Environment in the Atlantic Partnership for Tomorrow's Health Project. Nutrients 2020; 12:nu12103217. [PMID: 33096731 PMCID: PMC7588981 DOI: 10.3390/nu12103217] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 10/15/2020] [Accepted: 10/20/2020] [Indexed: 11/17/2022] Open
Abstract
An understanding of relationships between different constructs of the neighbourhood environment and diet quality is needed to inform public health interventions. This study investigated associations between material deprivation, social deprivation and population density with diet quality in a cohort of 19,973 Canadian adults aged 35 to 69 years within the Atlantic PATH cohort study. Diet quality, a metric of how well diet conforms to recommendations was determined from a 24-item food frequency questionnaire. Neighbourhood environment data were derived from dissemination area level Census data. Two deprivation indices were evaluated: material and social deprivation, which reflect access to goods and amenities and social relationships. Multi-level models were used to estimate relationships (mean differences and 95% CI) between neighbourhood environment and diet quality, adjusting for covariates. Mean diet quality was lower in the most socially deprived neighbourhoods compared to the least socially deprived: −0.56, 95% CI (−0.88, −0.25). Relationships between diet quality and population density differed between urban and rural areas (p-interaction < 0.0001). In rural areas, diet quality was higher in intermediate-density neighbourhoods: 0.54, 95% CI (0.05, 1.03). In urban areas, diet quality was lower in intermediate-density and the most-dense neighbourhoods: −0.84, 95% CI (−1.28, −0.40) and −0.72, 95% CI (−1.20, −0.25). Our findings suggest socially deprived and high-density neighbourhoods are associated with lower diet quality and possible urban-rural differences in neighbourhood environment-diet quality relationships. Additional studies are needed to determine the temporal nature of relationships and whether differences in diet quality are meaningful.
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Yan M, Li C, Zhang L, Chen X, Yang X, Shan A, Li X, Wu H, Ma Z, Zhang Y, Guo P, Dong G, Liu Y, Chen J, Wang T, Zhao B, Tang NJ. Association between long-term exposure to Sulfur dioxide pollution and hypertension incidence in northern China: a 12-year cohort study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:21826-21835. [PMID: 32279275 DOI: 10.1007/s11356-020-08572-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 03/23/2020] [Indexed: 06/11/2023]
Abstract
Several studies have researched the short-term effect of sulfur dioxide (SO2) exposure on hypertension. However, no evidence has provided the relationship between long-term high pollution exposure of SO2 and morbidity of hypertension in cohort studies in China. This retrospective cohort study aimed to evaluate this association. We used Cox proportional hazards regression models to examine the hazard ratios (HR) for hypertension risks from 1998 to 2009 associated with accumulative exposure of air SO2 among adults in northern China. Annual average concentrations of sulfur dioxide (SO2) were obtained from 15 local environmental monitoring centers. Hypertension was identified according to self-reported diagnostic time and treatment for hypertension with anti-hypertensive medication. Among 37,386 participants, 2619 new cases of hypertension were identified during 426,334 person-years. In the fully adjusted model, HR and 95% confidence interval (CI) of hypertension incidence for each 10 μg/m3 increase in SO2 were 1.176 (1.163 and 1.189). Results from stratified analyses suggested that effects of SO2 on hypertension morbidity were more pronounced in participants < 60 years old, tea drinkers, and those with high education, high poultry consumption, and active (occasional and frequent) exercise. We found that long-term exposure to high levels of SO2 increased the risk of incidence of hypertension in China.
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Affiliation(s)
- Mengfan Yan
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, No. 22 Meteorological Station Road, Heping District, Tianjin, 300070, China
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, 300070, China
- Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, 300070, China
| | - Chaokang Li
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, No. 22 Meteorological Station Road, Heping District, Tianjin, 300070, China
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, 300070, China
- Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, 300070, China
| | - Liwen Zhang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, No. 22 Meteorological Station Road, Heping District, Tianjin, 300070, China
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, 300070, China
- Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, 300070, China
| | - Xi Chen
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, No. 22 Meteorological Station Road, Heping District, Tianjin, 300070, China
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, 300070, China
- Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, 300070, China
| | - Xueli Yang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, No. 22 Meteorological Station Road, Heping District, Tianjin, 300070, China
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, 300070, China
- Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, 300070, China
| | - Anqi Shan
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, No. 22 Meteorological Station Road, Heping District, Tianjin, 300070, China
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, 300070, China
- Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, 300070, China
| | - Xuejun Li
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, No. 22 Meteorological Station Road, Heping District, Tianjin, 300070, China
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, 300070, China
- Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, 300070, China
| | - Hui Wu
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, No. 22 Meteorological Station Road, Heping District, Tianjin, 300070, China
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, 300070, China
- Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, 300070, China
| | - Zhao Ma
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, No. 22 Meteorological Station Road, Heping District, Tianjin, 300070, China
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, 300070, China
- Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, 300070, China
| | - Yu Zhang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, No. 22 Meteorological Station Road, Heping District, Tianjin, 300070, China
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, 300070, China
- Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, 300070, China
| | - Pengyi Guo
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, No. 22 Meteorological Station Road, Heping District, Tianjin, 300070, China
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, 300070, China
- Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, 300070, China
| | - Guanghui Dong
- Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Yamin Liu
- School of Medicine and Life Sciences, Shandong Academy of Medical Sciences, Jinan, 250062, China
| | - Jie Chen
- Department of Occupational and Environmental Health, School of Public Health, China Medical University, No. 77 Puhe Road, Shenbei New District, Shenyang, 110122, China
| | - Tong Wang
- School of Public Health, Shanxi Medical University, Taiyuan, 030001, China
| | - Baoxin Zhao
- Taiyuan Center for Disease Control and Prevention, Taiyuan, 030001, China
| | - Nai-Jun Tang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, No. 22 Meteorological Station Road, Heping District, Tianjin, 300070, China.
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, 300070, China.
- Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, 300070, China.
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Gu Q, Dummer TBJ, Spinelli JJ, Murphy RA. Diet Quality among Cancer Survivors and Participants without Cancer: A Population-Based, Cross-Sectional Study in the Atlantic Partnership for Tomorrow's Health Project. Nutrients 2019; 11:nu11123027. [PMID: 31835839 PMCID: PMC6950144 DOI: 10.3390/nu11123027] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 12/09/2019] [Indexed: 02/08/2023] Open
Abstract
Cancer survivors are encouraged to have a healthy lifestyle to reduce health risks and improve survival. An understanding of health behaviors, such as diet, is also important for informing post-diagnosis support. We investigated the diet quality of cancer survivors relative to participants without cancer, overall and by cancer site and time from diagnosis. A cross-sectional study design within the Atlantic PATH study was used which included 19,973 participants aged 35 to 69 years from Atlantic Canada, of whom 1,930 were cancer survivors. A diet quality score was derived from a food frequency questionnaire. Comparisons of diet quality between cancer survivors and non-cancer controls, cancer site and years since diagnosis were examined in multivariable multi-level models. Cancer survivors had a mean diet quality of 39.1 out of 60 (SD: 8.82) and a higher diet quality than participants without cancer (mean difference: 0.45, 95% CI: 0.07, 0.84) after adjustment for confounders. Odds of high diet quality was greater in breast cancer survivors than participants without cancer (OR = 1.42, 95% CI: 1.06, 1.90), and higher among survivors diagnosed ≤2 years versus >10 years (OR = 1.71, 95% CI: 1.05, 2.80). No other differences by cancer site and years since diagnosis were observed. The difference in diet quality, although statistically significant, is unlikely to be meaningful, suggesting that cancer survivors have similar diet quality as participants without cancer. There was considerable room for dietary improvement regardless of cancer status, highlighting the need for dietary interventions, especially among cancer survivors, who are at higher risk for secondary health problems.
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Affiliation(s)
- Qianqian Gu
- School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z3, Canada; (Q.G.); (T.B.J.D.); (J.J.S.)
| | - Trevor B. J. Dummer
- School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z3, Canada; (Q.G.); (T.B.J.D.); (J.J.S.)
| | - John J. Spinelli
- School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z3, Canada; (Q.G.); (T.B.J.D.); (J.J.S.)
- Population Oncology, BC Cancer Agency, Vancouver, BC V5Z 1G1, Canada
| | - Rachel A. Murphy
- School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z3, Canada; (Q.G.); (T.B.J.D.); (J.J.S.)
- Cancer Control Research, BC Cancer Agency, 675 W 10th Ave, Vancouver, BC V5Z 1L3, Canada
- Correspondence: ; Tel.: +1-604-822-1397
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Bermúdez-Millán A, Wagner JA, Feinn RS, Segura-Pérez S, Damio G, Chhabra J, Pérez-Escamilla R. Inflammation and Stress Biomarkers Mediate the Association between Household Food Insecurity and Insulin Resistance among Latinos with Type 2 Diabetes. J Nutr 2019; 149:982-988. [PMID: 31006809 PMCID: PMC6543200 DOI: 10.1093/jn/nxz021] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 11/27/2018] [Accepted: 01/28/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Household food insecurity (HFI) is a stressor that is associated with type 2 diabetes (T2D). However, little is known about HFI and the insulin resistance (IR) underlying T2D, and the mechanisms involved. OBJECTIVE We examined the cross-sectional association between HFI and IR among low-income Latinos with T2D and tested whether inflammation and stress hormones mediated this association. METHODS HFI was measured with the 6-item US Household Food Security Survey module. IR was calculated from fasting plasma blood glucose and serum insulin. Inflammation was indicated by high-sensitivity C-reactive protein (hsCRP), and stress hormones included urinary cortisol, metanephrine, and normetanephrine. To test for an indirect effect of HFI on homeostasis model assessment of IR, a parallel multiple mediation model was run with biological markers that significantly differed between food security status-entered as mediators in the model. We used 95% bias-corrected bootstrap CIs, with 10,000 bootstrap samples, to assess the significance of the indirect effects. RESULTS The 121 participants with T2D were primarily Puerto Rican (85.8%), aged mean = 60.7 y, and 74% were female. Eighty-two (68%) were classified as food insecure. Compared with food-secure individuals, food-insecure individuals had a significantly higher IR [mean difference (Δ) = 7.21, P = 0.001], insulin (Δ = 9.7, P = 0.019), glucose (Δ = 41, P < 0.001), hsCRP (Δ = 0.8, P = 0.008), cortisol (Δ = 21, P = 0.045), and total cholesterol (Δ = 29, P = 0.004). Groups did not differ on other lipids, metanephrine, normetanephrine, or A1c. The mediation model showed a significant direct effect of HFI on hsCRP (P = 0.020) and on cortisol (P = 0.011). There was a direct effect of cortisol (P = 0.013), hsCRP (P = 0.044), and HFI on IR (P = 0.015). The total combined indirect effect of HFI through cortisol and hsCRP indicated partial mediation. CONCLUSIONS Among Latinos with T2D, HFI is associated with IR partially through inflammation and stress hormones. Interventions to ameliorate HFI and mitigate its effects on inflammation, stress, and IR are warranted. This trial was registered at clinicaltrials.gov as NCT01578096.
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Affiliation(s)
| | - Julie A Wagner
- Psychiatry, University of Connecticut School of Medicine
- Division of Behavioral Sciences and Community Health, University of Connecticut School of Dental Medicine, UConn Health, Farmington, CT
| | - Richard S Feinn
- School of Medicine, Medical Sciences, Quinnipiac University, Hamden, CT
| | | | | | - Jyoti Chhabra
- Research Administration, Hartford Hospital, Hartford, CT
| | - Rafael Pérez-Escamilla
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT
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Bermúdez-Millán A, Wagner JA, Feinn RS, Segura-Pérez S, Damio G, Chhabra J, Pérez-Escamilla R. Inflammation and Stress Biomarkers Mediate the Association between Household Food Insecurity and Insulin Resistance among Latinos with Type 2 Diabetes. J Nutr 2019. [DOI: 10.1093/jn/nxz021 [doi]] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
ABSTRACT
Background
Household food insecurity (HFI) is a stressor that is associated with type 2 diabetes (T2D). However, little is known about HFI and the insulin resistance (IR) underlying T2D, and the mechanisms involved.
Objective
We examined the cross-sectional association between HFI and IR among low-income Latinos with T2D and tested whether inflammation and stress hormones mediated this association.
Methods
HFI was measured with the 6-item US Household Food Security Survey module. IR was calculated from fasting plasma blood glucose and serum insulin. Inflammation was indicated by high-sensitivity C-reactive protein (hsCRP), and stress hormones included urinary cortisol, metanephrine, and normetanephrine. To test for an indirect effect of HFI on homeostasis model assessment of IR, a parallel multiple mediation model was run with biological markers that significantly differed between food security status—entered as mediators in the model. We used 95% bias-corrected bootstrap CIs, with 10,000 bootstrap samples, to assess the significance of the indirect effects.
Results
The 121 participants with T2D were primarily Puerto Rican (85.8%), aged mean = 60.7 y, and 74% were female. Eighty-two (68%) were classified as food insecure. Compared with food-secure individuals, food-insecure individuals had a significantly higher IR [mean difference (Δ) = 7.21, P = 0.001], insulin (Δ = 9.7, P = 0.019), glucose (Δ = 41, P < 0.001), hsCRP (Δ = 0.8, P = 0.008), cortisol (Δ = 21, P = 0.045), and total cholesterol (Δ = 29, P = 0.004). Groups did not differ on other lipids, metanephrine, normetanephrine, or A1c. The mediation model showed a significant direct effect of HFI on hsCRP (P = 0.020) and on cortisol (P = 0.011). There was a direct effect of cortisol (P = 0.013), hsCRP (P = 0.044), and HFI on IR (P = 0.015). The total combined indirect effect of HFI through cortisol and hsCRP indicated partial mediation.
Conclusions
Among Latinos with T2D, HFI is associated with IR partially through inflammation and stress hormones. Interventions to ameliorate HFI and mitigate its effects on inflammation, stress, and IR are warranted. This trial was registered at clinicaltrials.gov as NCT01578096.
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Affiliation(s)
| | - Julie A Wagner
- Psychiatry, University of Connecticut School of Medicine
- Division of Behavioral Sciences and Community Health, University of Connecticut School of Dental Medicine, UConn Health, Farmington, CT
| | - Richard S Feinn
- School of Medicine, Medical Sciences, Quinnipiac University, Hamden, CT
| | | | | | - Jyoti Chhabra
- Research Administration, Hartford Hospital, Hartford, CT
| | - Rafael Pérez-Escamilla
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT
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Meyer S, Cole R. Army Body Composition Program Study Results Concerning: Enrollees Are More Over Fat Than Expected. Mil Med 2019; 184:400-408. [PMID: 30901401 DOI: 10.1093/milmed/usy302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 10/02/2018] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION Whether implementation of the Army Body Composition Program (ABCP) is meeting readiness objectives is unknown. OBJECTIVE This study sought to primarily describe the extent of Active Duty Soldiers' over-fatness when attending the initial ABCP nutrition class at an Army Nutrition clinic in Washington State; and secondarily to describe the proportion of these Soldiers meeting metabolic syndrome (MS) criteria. METHODS Soldiers (189) in this cross-sectional study completed the following: a questionnaire developed for this study, anthropometric measurements, body fat assessment via AR 600-9 standards, and a laboratory blood draw for fasting glucose and lipid panel. RESULTS Soldiers were predominantly male (76%), obese (BMI 32 kg/m2 for males and 30 kg/m2 for females), exceeded body fat standards by 3.8% for males and 7.3% for females, and 16% had three or more risk factors meeting MS diagnostic criteria. Waist circumference was the predominant MS risk factor for males and females. CONCLUSION Soldiers in this study had higher body fat percentages than expected with a majority of Soldiers classified as obese. Achieving and maintaining ABCP standards may be more challenging for obese Soldiers. To maintain Soldier readiness, commanders should consider intervening earlier when signs of weight gain are observed.
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Affiliation(s)
- Stephanie Meyer
- Army Medical Department Center and School, Health Readiness Center of Excellence, 3630 Stanley Road, Fort Sam Houston, TX
| | - Renee Cole
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, 10 General Greene Ave, Natick, MA
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12
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DeClercq V, Langille MGI, Van Limbergen J. Differences in adiposity and diet quality among individuals with inflammatory bowel disease in Eastern Canada. PLoS One 2018; 13:e0200580. [PMID: 30024912 PMCID: PMC6053167 DOI: 10.1371/journal.pone.0200580] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Accepted: 07/01/2018] [Indexed: 12/30/2022] Open
Abstract
The objective of the current study was to characterize the relationship between diet quality and body composition in participants living with IBD, specifically Crohn’s disease (CD) or ulcerative colitis (UC), in Atlantic Canada. Participants from the Atlantic Partnership for Tomorrow’s Health (PATH) study are residents of one of the four Atlantic Canada provinces. Participants who completed the dietary questionnaire and had body composition measured were included in the study (n = 12,462 without IBD, n = 111 CD, n = 119 UC). A greater number of participants with IBD reported having multiple chronic conditions compared to those without IBD. Those with UC had statistically higher body weight and body mass index (BMI) compared to those without IBD. Overall, significant positive correlations were observed between adiposity and servings of refined grains, and meats and alternatives such as eggs and fish, whereas negative correlations were observed with servings of vegetables, fruit, whole grains, and alternatives such as tofu, and nuts/seeds. Participants with IBD (both CD and UC) consumed more refined grains than those without IBD. Using logistic regression analysis, participants consuming more servings of vegetables and whole grains were less likely to have CD where as those consuming more serving of fruit and bean/legumes were less likely to have UC. In the Atlantic PATH cohort, which includes a region of the world with a high incidence of IBD, distinct differences in adiposity and diet quality were observed in individuals with specific types of IBD compared to those without. There is a need for collaborative efforts to address weight management and diet quality issues in those living with IBD in the Atlantic Canadian region.
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Affiliation(s)
- Vanessa DeClercq
- Population Cancer Research Program, Dalhousie University, Halifax, Nova Scotia, Canada
- * E-mail:
| | | | - Johan Van Limbergen
- Department of Pediatrics, Division of Pediatric Gastroenterology & Nutrition, IWK Health Centre, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Medicine, Division of Digestive Care and Endoscopy, Dalhousie University, Halifax, Nova Scotia, Canada
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13
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Zhen S, Ma Y, Zhao Z, Yang X, Wen D. Dietary pattern is associated with obesity in Chinese children and adolescents: data from China Health and Nutrition Survey (CHNS). Nutr J 2018; 17:68. [PMID: 29996840 PMCID: PMC6042200 DOI: 10.1186/s12937-018-0372-8] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Accepted: 06/26/2018] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Associations of dietary patterns in Chinese adolescents and children with later obesity have not previously been investigated. The purpose of the present study was to evaluate the associations between dietary patterns and the risk of obesity in Chinese adolescents and children by using a longitudinal design. METHODS Data from the China Health and Nutrition Survey (CHNS), a nationally representative survey, were used for our analysis. 489 participants 6-14 years of age were followed from 2006 to 2011. Factor analysis was used to identify the dietary patterns in Chinese adolescents and children. Ordered logistic regression models were used to examine the association between dietary patterns and later obesity. RESULTS Two dietary patterns were revealed by factor analysis, the traditional Chinese dietary pattern (with high intake of rice, vegetables, poultry, pork and fish and the modern dietary pattern (with high intake of wheat, processed meat and fast food). Children in the highest quartile and the second-highest quartile of the traditional Chinese dietary pattern was inversely associated with later obesity compared with children in the lowest quartile over 5 years (OR = 0.19, 95%CI: 0.09, 0.40 for Q4; OR = 0.47, 95%CI: 0.33, 0.67 for Q3); Children in the highest quartile of the modern dietary pattern was positively associated with later obesity compared with children in the lowest quartile over 5 years (OR = 2.02, 95%CI: 1.17, 3.48). CONCLUSIONS Dietary patterns in Chinese adolescents and children are associated with later obesity. These findings further confirm the importance of children's dietary patterns in later obesity and lay groundwork for dietary culture-specific interventions targeted at reducing rates of obesity in children and adolescents.
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Affiliation(s)
- Shihan Zhen
- China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province China
| | - Yanan Ma
- China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province China
| | - Zhongyi Zhao
- China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province China
| | - Xuelian Yang
- China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province China
| | - Deliang Wen
- China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province China
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14
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DeClercq V, Cui Y, Forbes C, Grandy SA, Keats M, Parker L, Sweeney E, Yu ZM, Dummer TJB. Correction: DeClercq, V.; et al. Association between Diet Quality and Adiposity in the Atlantic PATH Cohort. Nutrients 2017, 9, 1155. Nutrients 2018; 10:nu10050540. [PMID: 29701692 PMCID: PMC5986420 DOI: 10.3390/nu10050540] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 02/22/2018] [Accepted: 04/23/2018] [Indexed: 11/16/2022] Open
Abstract
The authors request the following corrections to their paper [1]. [...].
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Affiliation(s)
- Vanessa DeClercq
- Population Cancer Research Program, Department of Pediatrics, Dalhousie University, Halifax, NS B3H 4R2, Canada.
| | - Yunsong Cui
- Population Cancer Research Program, Department of Pediatrics, Dalhousie University, Halifax, NS B3H 4R2, Canada.
| | - Cynthia Forbes
- Population Cancer Research Program, Department of Pediatrics, Dalhousie University, Halifax, NS B3H 4R2, Canada.
| | - Scott A Grandy
- School of Health and Human Performance, Dalhousie University, Halifax, NS B3H 1T8, Canada.
| | - Melanie Keats
- School of Health and Human Performance, Dalhousie University, Halifax, NS B3H 1T8, Canada.
| | - Louise Parker
- Population Cancer Research Program, Department of Pediatrics, Dalhousie University, Halifax, NS B3H 4R2, Canada.
| | - Ellen Sweeney
- Population Cancer Research Program, Department of Pediatrics, Dalhousie University, Halifax, NS B3H 4R2, Canada.
| | - Zhijie Michael Yu
- Population Cancer Research Program, Department of Pediatrics, Dalhousie University, Halifax, NS B3H 4R2, Canada.
| | - Trevor J B Dummer
- Centre of Excellence in Cancer Prevention, School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z3, Canada.
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