Adult Cardiometabolic Health Research Articles

Greater protein intake at breakfast or as snacks and less at dinner is associated with cardiometabolic health in adults

Protein intake is inversely associated with waist circumference and positively associated with HDL-cholesterol concentrations. However, the relationship between protein intake during specific eating occasions and cardiometabolic health is not well documented. This cross-sectional study measured protein intake at meals and combined snacking occasions and evaluated associations between protein intake at meals or snacking occasions and markers of cardiometabolic health in adults. Deciles of individual usual intake (IUI) for protein at meals and combined snacking occasions were calculated using NHANES 2013-2016 data (n=10,112; ≥19y). Associations between protein intake at meals or snacks and markers of cardiometabolic health were determined using regression analysis. Covariates included age, age2, gender, ethnicity, physical activity level, poverty income ratio, protein IUI at other eating occasions, and total energy IUI at the eating occasion being analyzed (model 1). P<0.0042 was considered statistically significant. Registered as ISRCTN11120152. Protein intake ranged (10th to 90th percentiles) 5.9±0.1 to 22.6±0.3g/d at breakfast, 14.0±0.1 to 34.6±0.4g/d at lunch, 24.3±0.3 to 46.8±0.2g/d at dinner, and 4.9±0.1 to 16.5±0.2g/d at combined snacking occasions. Protein intake at breakfast was inversely associated with diastolic (-0.39±0.10, P=0.0003) and systolic (-0.40±0.13mmHg per decile, P=0.0038) blood pressure. Protein intake at breakfast was positively related to HDL-cholesterol (0.75±0.16mg/dL per decile, P=0.0001). Protein intake at dinner was positively associated with insulin concentrations (0.77±0.23 uU/mL per decile, P=0.0025) and the homeostatic model assessment of insulin resistance (HOMA-IR, 0.32±0.09 per decile, P=0.0017). Protein intake from snacks was inversely associated with diastolic blood pressure (-0.41±0.09mmHg per decile, P<0.0001) and CVD risk score (-0.0018±0.0004 per decile, P=0.0001). Protein intakes at meals and snacks were not associated with BMI, waist circumference, glucose, total cholesterol, LDL-cholesterol, or triglycerides. In adults, protein consumption at breakfast is inversely associated with systolic and diastolic blood pressure and positively associated with HDL-cholesterol, while protein consumption at dinner is positively associated with HOMA-IR and insulin concentrations.

Physical inactivity from youth to adulthood and adult cardiometabolic risk profile

Adults with a low physical activity (PA) level are at increased risk for cardiometabolic diseases, but little is known on the association between physical inactivity since youth and cardiometabolic health in adulthood. We investigated the association of persistent physical inactivity from youth to adulthood with adult cardiometabolic risk factors. Data were drawn from the ongoing Cardiovascular Risk in Young Finns Study with seven follow-ups between 1980 and 2011 (baseline age 3–18 years, n = 1961). Physical activity data from a standardized questionnaire was expressed as a PA-index. Using the PA-index, four groups were formed: 1)persistently physically inactive (n = 246), 2)decreasingly active (n = 305), 3)increasingly active (n = 328), and 4)persistently active individuals (n = 1082). Adulthood cardiometabolic risk indicators included waist circumference, body mass index (BMI), blood pressure, and fasting lipids, insulin, and glucose. Clustered cardiometabolic risk was defined using established criteria for metabolic syndrome. Persistently physically inactive group was used as a reference. Compared to the persistently physically inactive group, those who were persistently active had lower risk for adult clustered cardiometabolic risk (RR = 0.67;CI95% = 0.53–0.84; Harmonized criteria), obesity (BMI > 30 kg/m2, RR = 0.76;CI95% = 0.59–0.98), high waist circumference (RR = 0.82;CI95% = 0.69–0.98), and high triglyceride (RR = 0.60;CI95% = 0.47–0.75), insulin (RR = 0.58;CI95% = 0.46–0.74) and glucose (RR = 0.77;CI95% = 0.62–0.96) concentrations as well as low high-density lipoprotein cholesterol (HDLC) concentration (RR = 0.78;CI95% = 0.66–0.93). Comparable results were found when persistently physically inactive individuals were compared with those who increased PA. The results remained essentially similar after adjustment for education, diet, smoking, and BMI. Persistently physically inactive lifestyle since youth is associated with an unfavorable cardiometabolic risk profile in adulthood. Importantly, even minor increase in PA lowers the cardiometabolic risk.

Longitudinal smoking patterns and adult cardiometabolic risk among African Americans.

To better understand mechanisms influencing health in African Americans (AAs), the aims of this study were (a) to identify longitudinal cigarette smoking classes among AAs across adolescence and into young adulthood; (b) to identify risk factors for smoking and how cardiometabolic health in adulthood differs by smoking class; and (c) to investigate whether smoking mediates the relation between adolescent risk factors and adult cardiometabolic health. This study used 4 waves of nationally representative data, restricted to an AA subsample (N = 2,009). Participants self-reported on multilevel risk factors in adolescence and smoking across adolescence and young adulthood; cardiometabolic risk was assessed in adulthood. Growth mixture modeling and structural equation modeling were conducted. Five classes emerged: nonsmoker; early onset, heavier smoking; later onset; early onset, light smoking; and maturing out or declining smoking. Predictors of class membership included living with individuals who smoke, having friends who smoke, and limited access to medical care. The early onset, light smoking class had the greatest cardiometabolic risk. Smoking class mediated the relation between living with people who smoke in adolescence and adult cardiometabolic risk. Nuanced smoking patterns among AAs were identified, and 23% fell into classes characterized by an early onset and persistent smoking trajectory. The early onset, light smoking class had the greatest cardiometabolic risk in adulthood. The results suggest unique protective factors may be present for youth who remain nonsmokers even when their family smokes. Results have implications for health promotion and tobacco prevention efforts among AA families. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

33 - Objectively Measured Physical Activity, Sedentary Behaviour and Cardiometabolic Measures in Adults with Type 2 Diabetes: Results from the Canadian Health Measures Survey (2007-2017)

Clinical practice guidelines recommend ≥150 minutes/week of moderate-to-vigorous-intensity physical activity (MVPA) in adults with type 2 diabetes. However, self-reported physical activity data suggest that most adults with type 2 diabetes are insufficiently active. Our aim was to evaluate the associations between objectively measured physical activity, sedentary behaviour and cardiometabolic health in adults with type 2 diabetes in a representative sample of the Canadian population.

Association of Body Mass Index in Youth With Adult Cardiometabolic Risk.

BackgroundWhether long‐term exposure to overweight or obesity from early life to adulthood has a detrimental influence on health outcomes is unknown. We aimed to investigate whether duration of overweight or obesity from youth to adulthood is associated with adult cardiometabolic risk.Methods and ResultsA population‐based cohort study was performed of 1268 youths, aged 3 to 18 years, with follow‐ups at 3, 6, 9, 12, 21, 27, and 31 years. Duration of overweight or obesity over 31‐year follow‐up was calculated. Adulthood outcomes included type 2 diabetes mellitus, impaired fasting glucose, high insulin levels, high carotid intima‐media thickness, hypertension, low high‐density lipoprotein cholesterol, high low‐density lipoprotein cholesterol and triglycerides, arterial pulse wave velocity, carotid artery compliance, Young elastic modulus, and stiffness index. Rates of overweight/obesity were 7.9% at baseline and 55.9% after 31 years. After adjustment for confounders, longer duration of overweight or obesity was associated with increased risk of all outcomes (relative risk ranged from 1.45–9.06 for type 2 diabetes mellitus, impaired fasting glucose, carotid intima‐media thickness, hypertension, high‐density lipoprotein cholesterol, low‐density lipoprotein cholesterol, and triglycerides; β from 0.370–0.543 m/s for pulse wave velocity; –0.193 to –0.237 %/10 mm Hg for carotid artery compliance; 52.1–136.8 mm Hg·mm for Young elastic modulus; and 0.554–0.882 for stiffness index). When body mass index was further adjusted, these associations disappeared or were substantially reduced. Detrimental associations of adult body mass index with all outcomes were robust to adjustment for confounders and duration of overweight or obesity.ConclusionsOverweight or obesity in adulthood rather than childhood appears to be more important for adult cardiometabolic health.

Resistance Training And High-intensity Interval Training Improve Cardiometabolic Health In Older Adults: A Meta-analysis

PURPOSE: Older adults have an increased risk of developing cardiometabolic disease including cardiovascular disease and type 2 diabetes. Progressive resistance training (PRT) and high-intensity interval training (HIIT) individually improve cardiometabolic health (CMH) in older adults. However, whether a combination of the two prescriptions provides greater benefit is yet to be explored. We conducted a systematic review and meta-analysis of controlled trials investigating the effect of PRT, HIIT and combination PRT+HIIT (COMB) on CMH in older adults with moderate cardiometabolic risk. METHODS: Nine databases were searched from inception until September 2019. We included studies comparing PRT, HIIT or COMB vs usual care that reported ≥2 modifiable CMH risk factors. Standardized mean (SMD) and mean differences (MD) were calculated using a random-effects inverse variance model. Heterogeneity and risk of bias were assessed according to Cochrane guidelines. RESULTS: We analysed 451 participants from ten studies (7 PRT, n=149, 2 HIIT, n=25, 1 COMB, n=60), 40.6% male with a mean age of 67.7±1.8 years. Training ranged from 2-4 times per week for 22±16 weeks. Compared to usual care, exercise significantly improved body mass index (BMI) (MD -0.36 [-0.50,-0.22], p≤0.0001), body fat % (BF%) (SMD -0.60 [-1.13, -0.06], p=0.03), peak aerobic capacity (SMD 0.40 [0.13, 0.68], p=0.004), triglycerides (SMD -0.22 [-0.45, 0.00] p=0.05) and fasting blood glucose (FBG) (SMD -0.30 [-0.54, -0.05], p=0.02). PRT alone significantly improved BMI (MD -0.37 [-0.53, -0.21], p=0.00001), BF% (SMD -0.91 [-1.70, -0.13], p=0.02) and lean body mass (SMD 0.96 [0.05, 1.87], p=0.04). COMB improved triglycerides (SMD -0.44 [-0.79, -0.08], p=0.02) and FBG (SMD -0.41 [-0.76, -0.05], p=0.02). CONCLUSIONS: Exercise improves CMH in older adults, with PRT interventions eliciting significant improvements in body composition. COMB exercise was the only modality to improve triglycerides and blood glucose. Further research is warranted on COMB, HIIT and PRT training, focusing on volume and intensity to investigate differences in effect. More thorough CMH outcome and exercise prescriptive element reporting is warranted in order to identify optimal exercise prescription for improving CMH in older adults.

Potatoes Incorporated into a Higher Protein Diet for 16-Weeks Do Not Influence Cardiometabolic Health in Adults with Metabolic Syndrome: A Pilot Study

Abstract Objectives To determine if consuming four servings of white potatoes, processed potato products, or starchy carbohydrates for 16 weeks, as part of a higher protein diet, influence markers of cardiometabolic health in adults with metabolic syndrome. Methods Eleven adults with metabolic syndrome were randomly assigned to one of three higher protein diets incorporating different carbohydrate sources: 1) 4 servings of potatoes/week (P; n = 4; 4 female; 48.3 ± 9.4 y; 92.4 ± 9.6 kg; 36.3 ± 4.3 BMI); 2) processed potatoes (PP; n = 2; 1 female,1 male; 53.0 ± 15.0 y; 81.4 ± 17.0 kg; 29.6 ± 3.0 BMI); or 3) starchy carbohydrate (SC; n = 5; 4 female,1 male; 33.6 ± 5.0 y; 95.1 ± 18.2 kg; 35.3 ± 4.7 BMI). Data was collected at baseline, 4, 8,12, and 16 weeks. Glucose, cholesterol, and triglycerides were analyzed using a Cholestech LDX Analyzer. Height, weight, waist-to-hip ratio, blood pressure, mood, sleep quality, and grit were also measured. Body composition was measured using DEXA. Data were analyzed using Prism GraphPad version 8.0. Significance was set at P &amp;lt; 0.05. Results There were no significant changes in body weight, BMI, waist-to-hip ratio, or body composition within or between each group. However, an increase in bone mineral density was observed within all groups(P &amp;lt; 0.05). There was no effect of diet on plasma glucose and lipid levels. In addition, there was no change in blood pressure within each group. However, diastolic blood pressure decreased (P &amp;lt; 0.05) in all groups. There were no changes in mood and grit. However, sleep quality improved within all groups (P &amp;lt; 0.05). In addition, grip strength improved (P &amp;lt; 0.05) within all groups. Conclusions The preliminary results of this study indicate that incorporating white potatoes, processed potatoes, or starch carbohydrates into a higher protein diet, does not influence markers of cardiometabolic health in adults with metabolic syndrome. Higher protein diets, may improve secondary outcomes such as sleep quality, bone mineral density, and grip strength. However, a larger study population is needed. Funding Sources Alliance for Potato Research and Education.

Effect of a 12-Week Almond-Enriched Diet on Biomarkers of Cognitive Performance, Mood, and Cardiometabolic Health in Older Overweight Adults.

Long term nut consumption is associated with reduced risk of coronary heart disease and better cognitive function. This study examined supplementing habitual diets with almonds or carbohydrate-rich snack foods (providing 15% energy) on biomarkers of cardiovascular and metabolic health, mood and cognitive performance. Participants (overweight/obese, 50–80 years) were randomised to an almond-enriched diet (AED) or isocaloric nut-free diet (NFD) for 12 weeks. Body weight, blood lipids, glucose, insulin, blood pressure (BP), arterial stiffness, cell adhesions molecules, C reactive protein (CRP), mood, and cognitive performance (working memory primary outcome), dietary profiles and energy intake/expenditure were measured at baseline and Week 12 in 128 participants (n = 63 AED, n = 65 NFD). Compared with NFD, AED was associated with altered macro and micronutrient profiles, but no differences in energy intake or expenditure. The AED significantly reduced triglycerides and SBP but there were no other changes in cardiometabolic biomarkers, mood, or cognitive performance. The inclusion of almonds in the diet improves aspects of cardiometabolic health without affecting cognitive performance or mood in overweight/obese adults.

Abstract MP22: Association Of Intra-individual Daily Variability In Sleep With Metabolic Outcomes In Youth: Multidimensional Assessment Of Preschoolers Study (MAPS)

Background: Average nightly sleep duration is associated with cardiometabolic health; both short- and long-sleep are associated with obesity, diabetes, hypertension and cardiovascular disease. An equally important measure of cardiometabolic health is an individual’s daily variability (DV) in sleep timing and duration. Greater intra-individual DV is associated with less favorable cardiometabolic health in adults, but less is known about the association of DV with cardiometabolic health in youth. We hypothesize that DV in sleep timing and duration is associated with less favorable body mass index (BMI), systolic blood pressure and waist girth among youth. Methods: Boys and girls aged 9-13 years old who wore the Actigraph GT-3X BT on their non-dominant wrist for a minimum of 4 days and had available measures of cardiometabolic health were included in the analysis (N=91). Validated algorithms from ActiLife software were used to determine daily total sleep time, sleep efficiency, sleep onset and time out of bed. We calculated DV in sleep onset, time out of bed and duration as the coefficient of variation (CV = standard deviation/overall mean). Average sleep measures were calculated across the days worn. We modeled the association of each sleep measure with metabolic outcomes using multivariable linear regression. Results: On average, participants slept for 7.23 (SD=1.4) hours per night, BMI percentile (BMI%) was 63.0 (SD=30.9), waist girth was 66.7 cm (SD=10.8) and systolic blood pressure percentile (SBP%) was 41.4 (SD= 21.4). Higher DV in sleep onset was associated with significantly higher BMI% and positively associated with SBP%. There was no association of average sleep measures with any outcomes. Findings were consistent by sex and age. Conclusions: Daily variability in time to sleep in youth was associated with higher BMI% and a modest association with SBP%. Future studies should test whether promoting consistent bedtimes can improve cardiometabolic health.

Estimated cardiorespiratory fitness in childhood and cardiometabolic health in adulthood: 1970 British Cohort Study.

BackgroundAssociations of cardiorespiratory fitness in childhood and adulthood with adult cardiometabolic risk factors are poorly understood, not least because of the paucity of studies.ObjectivesWe investigated associations between nonexercise testing cardiorespiratory fitness (NETCRF) in childhood/adulthood and cardiometabolic risk factors in adulthood.MethodsBased on an established algorithm comprising gender, age, body mass index, resting heart rate, and self‐reported physical activity at age 10, we computed NETCRF. Risk factors were assessed at age 46 in 5009 participants when NETCRF was again calculated. Linear regression was used to summarize associations between NETCRF in childhood and risk factors in adulthood and, additionally, the relationship between NETCRF in adulthood and risk factors in adulthood after adjusting for childhood NETCRF.ResultsInconsistent associations were observed between childhood NETCRF and adult risk factors. NETCRF in adulthood was associated with blood pressure [−5.8 (−6.7, −4.9)], glycated hemoglobin [−3.41 (−4.06, −2.76)], total cholesterol [−0.16 (−0.24, −0.08)], HDL cholesterol [0.19 (0.16, 0.22)], triglycerides [−0.68 (−0.85, −0.50)], and C‐reactive protein [−0.29 (−0.35, −0.22)] in adult males. Similar associations were observed in adult females. Compared to those with low estimated fitness in both childhood and adulthood, participants with low fitness in childhood and high fitness in adulthood had a lower risk of two or more cardiometabolic risk factors (odds ratio: 0.25; 95% confidence interval: 0.19, 0.31).ConclusionAssociations between estimated fitness and risk factors are stronger in adulthood than from childhood to adulthood. Adults with previously sedentary childhoods may still gain benefits from improving their fitness.

Maternal Education in Early Life and Risk of Metabolic Syndrome in Young Adult American Females and Males: Disentangling Life Course Processes Through Causal Models.

Maternal education in a child's early life may directly affect the child's adult cardiometabolic health, but this is difficult to disentangle from biological, social, and behavioral life course processes that are associated with maternal education. These processes may also differ between males and females. Using data from the National Longitudinal Study of Adolescent to Adult Health (1995-2009) (N = 4,026 females and 3,192 males), we estimated sex-stratified associations between maternal attainment of less than high school (<HS), high school diploma (HS), or college degree (CD) at the respondent's birth and respondent's risk of metabolic syndrome (MetS); we used marginal structural models (MSM) to account for the influence of major life course risk factors, such as childhood maltreatment, adolescent overweight, adult education, household income, smoking, and physical activity, in mediating associations between maternal education and offspring MetS risk. Each higher level of maternal education was associated with a 36% (Relative Risk = 0.64 [95% Confidence Interval (CI): 0.50-0.82]) reduced risk of MetS among females, but only 19% (RR = 0.81 [95% CI: 0.64-1.01]) reduction among males (P-value interaction < 0.05). Stronger inverse associations were also observed for waist circumference and glycated hemoglobin (HbA1c) among females compared with males (-5 cm vs. -2.4 cm and -1.5% vs. -1.0%, respectively). High maternal education in early life was associated with a lower risk of MetS in young adulthood even after accounting for life course risk factors, particularly among females. Results were robust to altered model specifications.

Cluster patterns of behavioural risk factors among children: Longitudinal associations with adult cardio-metabolic risk factors

Much of what is known about childhood clusters of cardiovascular disease behavioural risk factors (RFs) comes from cross-sectional studies, providing little insight into the long-term health impacts of different behavioural cluster profiles. This study aimed to establish the longitudinal relationship between cluster patterns of childhood behavioural RFs and adult cardio-metabolic RFs.Data were from an Australian prospective cohort study of 1265 participants measured in 1985 (ages 9–15 yrs), and in 2004–06 (ages 26–36 yrs). At baseline, children self-reported smoking status, alcohol consumption, physical activity (PA), dietary behaviour and psychological well-being. At follow-up, participants completed questionnaires and attended study clinics where the following component indicators of the metabolic syndrome (MetS) score were measured: waist circumference, blood pressure, fasting blood glucose and lipids. TwoStep cluster analyses were carried out to identify clusters in childhood. Linear regression was used to examine the longitudinal associations between cluster patterns of childhood behavioural RFs and adult cardio-metabolic RFs.Four childhood cluster patterns of behavioural RFs labelled ‘most healthy’, ‘high PA’, ‘most unhealthy’, and ‘breakfast skippers’ were identified. The unhealthier childhood clusters predicted a significantly higher adult MetS score (‘most unhealthy’: β = 0.10, 95%CI = 0.01, 0.19) and adult waist circumference (‘most unhealthy’: β = 2.29, 95%CI = 0.90, 6.67; ‘breakfast skippers’: β = 2.15, 95%CI = 0.30, 4.00). These associations were independent of adult behavioural RFs and socio-economic position.These findings emphasise the impact of multiple childhood behavioural RFs on important adult health outcomes and may be useful for the development of early intervention strategies, where identification of children at higher risk of poorer adult cardio-metabolic health is vital.

Association of Pubertal Development With Adiposity and Cardiometabolic Health in Girls and Boys—Findings From the Generation XXI Birth Cohort

PurposeEarly timing of pubertal development is associated with worse cardiometabolic health in adulthood. We aimed to evaluate this association in 10-year-old girls and boys and clarify if it is independent of previous body mass index (BMI). MethodsPubertal development was evaluated through the Tanner scale in 4,548 children from the birth cohort Generation XXI. Data on anthropometrics, body composition, blood pressure, lipid profile, fasting plasma glucose, insulin, homeostatic model assessment–insulin resistance (HOMA-IR), and high-sensitivity C-reactive protein were collected. Bonferroni correction was applied, using an alpha of .004 for statistical significance. Regression coefficients and 99.6% confidence intervals were computed using linear regression models. ResultsGirls with a Tanner stage ≥2 presented statistically significant higher values of BMI, waist circumference (WC), waist-to-height ratio, fat mass index, blood pressure, glucose, insulin, HOMA-IR, triglycerides, and high-sensitivity C-reactive protein and lower values of high-density lipoprotein cholesterol. Boys with a Tanner stage ≥2 presented statistically significant higher values of BMI, WC, systolic blood pressure, and HOMA-IR and lower values of high-density lipoprotein cholesterol. After adjustment, including previous BMI, a Tanner stage ≥2 remained associated with BMI z-score (girls β = .41 [.32, .50]; boys β = .10 [.01, .19]) and WC (girls β = 2.64 cm [1.86, 3.43]; boys β = .81 cm [.11, 1.51]), and only in girls with waist-to-height ratio (β = .01 [.00, .01]), fat mass index (β = .31 kg/m2 [.08; .54]), glucose (β = 1.59 mg/dL [.85, 2.33]), insulin (β = 1.73 μU/mL [.68, 2.78]), and HOMA-IR (β = .40 [.16, .64]). ConclusionsIndependently of previous BMI, preteens with early puberty already had more adiposity at age 10 years. In addition, girls had higher glucose, insulin, and HOMA-IR, which may predict a worse glucose metabolism. These preteens should be a target for public health interventions.

Intermittent energy restriction is comparable to continuous energy restriction for cardiometabolic health in adults with central obesity: A randomized controlled trial; the Met-IER study

Short bouts of severe energy restriction may have additional, beneficial cardiometabolic effects beyond that of weight loss. We aimed to assess the short-term effects of intermittent fasting on insulin sensitivity and related cardiometabolic mechanisms. This parallel arm, randomized controlled trial compared the short-term effects of intermittent and continuous energy restriction (IER and CER) diets on markers of cardiometabolic health in individuals with central obesity, aiming for equivalent weight loss on both diets. Outcomes were assessed in non-smoking men and women (35-75y), following 4-wk IER (48h 600kcal/d followed by 5-day healthy eating advice) or CER diets (-500kcal/d healthy eating advice). The primary outcome was the revised quantitative insulin sensitivity check index (R-QUICKI), an indirect estimate of insulin sensitivity. Secondary outcomes included ambulatory blood pressure (ABP), indicators of sympathetic activity (heart rate variability (HRV) and normetanephrine), and markers of glucose homeostasis/insulin resistance, adiposity, lipids and inflammation. Forty-three participants completed the study. Reductions in body weight were equivalent in both groups: mean loss (%)-2.6; 95% CI-3.3,-1.9 and-2.9;-3.6,-2.1 for CER and IER, respectively, P=0.464). R-QUICKI increased following IER and CER, with no between-diet differences (overall mean increase (%) 6.6; 3.6, 9.6). Fasting plasma glucose concentrations decreased after CER but not after IER (mean difference CER-IER - 4.8% (0.7, 8.9), P<0.05) and fasting plasma non-esterified fatty acid concentrations were lower after IER compared to CER (mean difference CER-IER 0.15mmol/L (0.06, 0.24), P<0.005). There were no differences in lipids, adipokine/inflammatory markers, ABP or HRV between diets. Short-term CER or IER diets are comparable in their effects on most markers of cardiometabolic risk, although adaptive changes in glucose and fatty acid metabolism occur. This study is registered at clinicaltrials.gov as NCT02679989.

Childhood adversity and women\u2019s cardiometabolic health in adulthood: associations with health behaviors, psychological distress, mood symptoms, and personality

BackgroundWe tested whether childhood adversity is associated with poor cardiometabolic health in adulthood among a sample of overweight or obese Dutch women of reproductive age. Health behaviors, psychological distress, mood symptoms, or personality traits were included as potential mediators.MethodsData came from a follow-up visit (N = 115), carried out in 2016/2017, of a randomized controlled lifestyle intervention trial in 577 obese infertile women. The associations between total adversity exposure score and cardiometabolic health were tested with regression models. Sleep, smoking and eating behavior, symptoms of depression, anxiety and stress, and personality traits were potential mediators.ResultsChildhood adversity scores were not associated with cardiometabolic outcomes but were associated with poorer sleep quality score (M = 7.2 (SD = 3.5) for those with ≥2 types of events versus 4.8 (2.9) for those with no events; p = 0.022), higher external eating score (26.4 (8.7) versus 21.8 (10.3); p = 0.038), higher perceived stress score (17.1 (6.8) versus 12.3 (4.5); p = 0.016), post-traumatic stress score (1.9 (1.5) versus 0.6 (1.1); p < 0.001), and lower agreeableness score (28.2 (4.2) versus 30.3 (3.1); p = 0.035).ConclusionChildhood adversity was associated with poorer health behaviors including sleep and eating behavior, and more stress-related symptoms, but not with women’s cardiometabolic health.

Barriers to Consuming Dietary Protein and Cardiometabolic Risk Factors Among Low-Income and Homeless Adults (P04-089-19)

ObjectivesOver 40 million Americans identify as food insecure and lack access to adequate food. The objective of this study was to identify the barriers to consuming dietary protein and to determine how lack of access to dietary protein is associated with cardiometabolic risk factors in food insecure (FI) and homeless adults MethodsParticipants were recruited during intake at a medical outreach event for homeless and low-income adults living in Northwest Arkansas. A total of 96 adults (62 male and 33 female; 50.3 ±13.3 y) completed the survey. Subjects were asked to verbally respond to questions regarding their current housing and food security status, dietary habits, and general access to medical care. Cardiometabolic risk factors (BMI, glucose, and blood pressure) were also measured. Data was analyzed using Statistical Package for the Social Science v25. ResultsA total of 74.8% of participants reported some degree of FI. The majority of FI participants reported high- (32.6%) followed by moderate- (31.5%) and low-severity (16.3%); almost half of the participants (44.8%) reported being homeless. Barriers to protein consumption were positively correlated with FI (r = .36; P < .001). Over 70% of participants reported at least one barrier that prevented them from consuming protein. The majority reported that cost was the most important barrier to accessing protein (58%), followed by convenience (25%) and time available to prepare it (22%). In part, due to these and other barriers, more than one-third of respondents reported consuming protein fewer than 5 times per week. There were no associations between FI and cardiometabolic risk factors. Nevertheless, the majority of participants screened (88%) had blood pressure above 120/80 mm and had elevated blood glucose (39.7%) and 76% were either overweight or obese. ConclusionsBarriers to consuming dietary protein exist among homeless and low-income adults. Cost and convenience are the two most important barriers among this population subgroup; persons reporting barriers to protein access also reported higher levels of FI. Additionally, food insecurity and homelessness may increase risk for irregular cardiometabolic biomarkers. Future research will focus on how to overcome these barriers and improve markers of cardio metabolic health in adults experiencing FI. Funding SourcesAmerican Egg Board/Egg Nutrition Center.

Twelve Weeks of Egg Supplementation Does Not Alter Cardiometabolic Parameters in Food Insecure Adults (P08-073-19)

ObjectivesTo determine if egg consumption for twelve weeks improves markers of cardiometabolic health in adults living in a food insecure environment. MethodsTwenty adults were recruited to participate in a 12-week dietary intervention. Each participant was required to consume two eggs per day, five days per week without altering current dietary habits. Participants were either assigned to a food insecure (FI; n = 10; 8 female, 2 male; 38.0 ± 5.2 y; 74.2 ± 23.4 kg; BMI 28.5 ± 9.6) or food secure (FS; n = 10; 9 female, 1 male; 38.4 ± 4.1 y; 79.3 ± 17.1 kg; BMI 28.1 ± 5.4) group. FI was determined using the USDA’s six item Short Form Food Security Survey or enrolled in SNAP. Prior to starting the study, participants received nutritional counseling and educational materials regarding food preparation and egg consumption. Data was collected at baseline, 4-, 8-, and 12-weeks. Fasting plasma and serum samples were collected at each visit. Glucose and triglycerides were analyzed using commercially available kits. Height, weight, and waist-to-hip ratio were also measured. Data were analyzed via two-way ANOVA using Prism GraphPad version 8.0. Significance was set at P < 0.05). ResultsThere were no significant changes in body weight, BMI, or waist-to-hip ratio in either FI or FS participants. In addition, there was no effect of egg supplementation on plasma triglycerides in either group. Fasting glucose decreased after twelve weeks in the FS group (P < 0.05). ConclusionsThe results of this study indicate that regular consumption of eggs for twelve weeks does not impact body weight or triglycerides in either FI or FS adults, but may improve blood glucose levels. However, a larger study population and longer intervention period are needed. NCT NCT03412825. Funding SourcesThis study was funded by the American Egg Board/Egg Nutrition Center.

Childhood health motivation and adult cardiometabolic health in the Childhood Determinants of Adult Health (CDAH) study.

This research examined if childhood health motivation was associated with adult health behaviors and objectively measured health outcomes. Data were from the Childhood Determinants of Adult Health study. Children aged 9 to 15 years in 1985 completed a questionnaire with health motivation items. In 2004-2006, when aged 26 to 36, participants completed assessments of health behaviors (smoking, diet, alcohol consumption, and physical activity) and cardiometabolic outcomes (body mass index, carotid intima-media thickness from ultrasound, and HOMA insulin resistance from fasting blood samples). Structural path regression analyses examined pathways from health motivation in childhood to adult cardiometabolic outcomes, mediated via adult health behaviors measured concurrently, controlling for age, sex and socioeconomic position. There were 6,230 (49% female) children with data on health motivation. There were two latent constructs: health motivation (4 items: visiting a dentist, visiting a doctor, knowing about your body, and eating a good diet) and risk motivation (3 items: not being a smoker, not being fat, and not drinking alcohol). Greater health motivation was directly associated with nonsmoking, lower carotid intima-media thickness, and lower body mass index in adulthood. Greater risk motivation was directly associated with smoking, higher alcohol consumption, and poorer diets in adulthood. It was also indirectly associated with higher carotid intima-media thickness and higher HOMA insulin resistance via poorer health behaviors. Health motivation during childhood appears important to maintain health across the life course. It could be a target for interventions to improve cardiovascular health in children and adults. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Supplemental Material for Childhood Health Motivation and Adult Cardiometabolic Health in the Childhood Determinants of Adult Health (CDAH) Study

Supplemental Material for Childhood Health Motivation and Adult Cardiometabolic Health in the Childhood Determinants of Adult Health (CDAH) Study

Association of maternal prenatal smoking GFI1-locus and cardio-metabolic phenotypes in 18,212 adults.

BackgroundDNA methylation at the GFI1-locus has been repeatedly associated with exposure to smoking from the foetal period onwards. We explored whether DNA methylation may be a mechanism that links exposure to maternal prenatal smoking with offspring's adult cardio-metabolic health.MethodsWe meta-analysed the association between DNA methylation at GFI1-locus with maternal prenatal smoking, adult own smoking, and cardio-metabolic phenotypes in 22 population-based studies from Europe, Australia, and USA (n = 18,212). DNA methylation at the GFI1-locus was measured in whole-blood. Multivariable regression models were fitted to examine its association with exposure to prenatal and own adult smoking. DNA methylation levels were analysed in relation to body mass index (BMI), waist circumference (WC), fasting glucose (FG), high-density lipoprotein cholesterol (HDL—C), triglycerides (TG), diastolic, and systolic blood pressure (BP).FindingsLower DNA methylation at three out of eight GFI1-CpGs was associated with exposure to maternal prenatal smoking, whereas, all eight CpGs were associated with adult own smoking. Lower DNA methylation at cg14179389, the strongest maternal prenatal smoking locus, was associated with increased WC and BP when adjusted for sex, age, and adult smoking with Bonferroni-corrected P < 0·012. In contrast, lower DNA methylation at cg09935388, the strongest adult own smoking locus, was associated with decreased BMI, WC, and BP (adjusted 1 × 10−7 < P < 0.01). Similarly, lower DNA methylation at cg12876356, cg18316974, cg09662411, and cg18146737 was associated with decreased BMI and WC (5 × 10−8 < P < 0.001). Lower DNA methylation at all the CpGs was consistently associated with higher TG levels.InterpretationEpigenetic changes at the GFI1 were linked to smoking exposure in-utero/in-adulthood and robustly associated with cardio-metabolic risk factors.FundEuropean Union's Horizon 2020 research and innovation programme under grant agreement no. 633595 DynaHEALTH.