Biomarkers Of Cardiometabolic Health Research Articles

Cardiometabolic, dietary and physical health in graduate paramedics during the first 12-months of practice – a longitudinal study

Objective: Shift work is an established risk factor for poor health yet is necessary for paramedics to provide continuous care to the public. It is unknown how early into a career shift work may begin to impact health. This study sought to identify changes in cardiometabolic health, diet, aerobic capacity, physical activity and health-related quality of life (HRQoL) in graduate paramedics during the first 12-months of their career. Methods: Fifty-six paramedics with no history of regular shift work (28 female, 28 male; median age 24.5, IQR 23-26 years) were recruited for this study. Dietary patterns (food frequency questionnaires) and HRQoL (36-Item Short Form Questionnaire) were assessed at baseline, 6- and 12-months. Body weight, body mass index (BMI) and blood samples (fasting lipids, glucose, insulin and C-reactive protein) were measured at baseline and 12-months to ascertain cardiometabolic health risk. A subset of participants (n = 19; 10 female, 9 male) wore a physical activity monitor for 12 months and completed baseline and 12-month maximal aerobic capacity assessments (V̇O2max). Results: Body weight and BMI decreased in males and increased in females (-0.7% versus 1.7%, p = 0.02). HRQoL and dietary intake did not change over 12-months, except for a small decrease in fat intake (-1%). Consumption of core/healthy foods was lower than recommended at all timepoints. Biomarkers of cardiometabolic health were within normal range and did not change over 12-months, excepting insulin where a small non-significant increase was seen (+0.5 mIU/L, p = 0.61). Baseline V̇O2max was 41.4 (37.1-49.1) ml.kg−1.min−1, with no change noted at 12-months. Comparison of quarterly physical activity data showed no difference in steps per day (p = 0.47) or moderate to vigorous physical activity (MVPA, p = 0.92) across the 12-months. Paramedics completed less MVPA on day shifts compared to rostered days off (-14.68 minutes, p = 0.04). Conclusions: Dietary patterns, HRQoL, cardiometabolic health, aerobic capacity and physical activity levels did not change meaningfully in the first year of practice. Some dietary behaviors and physical activity levels could be improved and may mitigate health effects of exposure to shift work. Long-term follow-up of this group may aid in developing programs to enhance health for paramedics and other health workers.

Aerobic and resistance exercise improve patient-reported sleep quality and is associated with cardiometabolic biomarkers in Hispanic and non-Hispanic breast cancer survivors who are overweight or obese: results from a secondary analysis.

Poor sleep quality affects nearly one-third of breast cancer survivors and is associated with insulin resistance. The purpose of this secondary analysis was to examine the effects of a 16-week exercise intervention on patient-reported sleep quality among breast cancer survivors and assess whether changes in patient-reported sleep quality were associated with cardiometabolic biomarkers. We explored Hispanic ethnicity as a moderator of the effects of exercise on patient-reported sleep quality. Breast cancer survivors who were overweight or obese were randomized to exercise (n = 50) or usual care (n = 50). The 16-week intervention included aerobic and resistance exercise. Patient-reported sleep quality (Pittsburgh Sleep Quality Index [PSQI]) and biomarkers of cardiometabolic health were assessed at baseline and post-intervention. Within- and between-group differences were assessed using general linear models repeated-measures analyses of variance and mixed-model repeated-measure analysis, respectively. Associations between changes in PSQI and cardiometabolic biomarkers were computed using Pearson correlations. Linear mixed-models were used to evaluate effect modification by ethnicity. Participants were 52 ± 10.4 years old, and over half were of Hispanic ethnicity. As compared to usual care, PSQI global scores improved significantly in the exercise group (mean between-group difference -2.2; 95% CI -3.2 to -0.6). Change in PSQI was inversely associated with changes in all cardiometabolic biomarkers (p < 0.01) among the exercise group. Ethnicity was found to moderate the effects of exercise training on global sleep quality (p < 0.001). An aerobic and resistance exercise intervention effectively improved patient-reported sleep quality in breast cancer survivors. Hispanic ethnicity as a moderator showed greater improvement in patient-reported sleep indicating Hispanic versus non-Hispanic breast cancer survivors may derive larger sleep benefits. NCT01140282.

Associations of Dairy Intake with Circulating Biomarkers of Inflammation, Insulin Response, and Dyslipidemia among Postmenopausal Women

BackgroundCardiometabolic diseases are prevalent in aging Americans. Although some studies have implicated greater intake of dairy products, it is not clear how dairy intake is related to biomarkers of cardiometabolic health. ObjectiveOur aim was to test the hypothesis that associations of dairy foods with biomarkers of lipid metabolism, insulin-like growth factor signaling, and chronic inflammation may provide clues to understanding how dairy can influence cardiometabolic health. DesignThis was a cross-sectional study in the Women's Health Initiative using baseline food frequency questionnaire data to calculate dairy intake. Participants/settingParticipants were 35,352 postmenopausal women aged 50 to 79 years at 40 clinical centers in the United States. Main outcome measuresBaseline (1993-1998) concentrations of 20 circulating biomarkers were measured. Statistical analysesMultivariable-adjusted linear regression was used to estimate percent difference in biomarker concentrations per serving of total dairy and individual foods (milk, cheese, yogurt, butter, and low-fat varieties). ResultsLower triglyceride concentrations were associated with greater intake of total dairy (–0.8% [95% CI –1.2% to –0.3%]), mainly driven by full-fat varieties. Individual dairy foods had specific associations with circulating lipid components. For example, greater total milk intake was associated with lower concentrations of total cholesterol (–0.4% [95% CI –0.7% to –0.2%]) and high-density lipoprotein cholesterol (–0.5% [95% CI –0.9% to –0.1%]), whereas greater butter intake was associated with higher total cholesterol (0.6% [95% CI 0.2% to 1.0%]) and high-density lipoprotein cholesterol (1.6% [95% CI 1.1% to 2.0%]) concentrations. In contrast, higher total yogurt intake was associated with lower total cholesterol (–1.1% [95% CI –2.0% to –0.2%]) and higher high-density lipoprotein cholesterol (1.8% [95% CI 0.5% to 3.1%]). Greater total dairy intake (regardless of fat content), total cheese, full-fat cheese, and yogurt were consistently associated with lower concentrations of glucose, insulin, and C-reactive protein. However, milk and butter were not associated with these biomarkers. ConclusionsHigher dairy intake, except butter, was associated with a favorable profile of lipids, insulin response, and inflammatory biomarkers, regardless of fat content. Yet, specific dairy foods might influence these markers uniquely. Findings do not support a putative role of dairy in cardiometabolic diseases observed in some previous studies.

Cardiometabolic Changes in Response to a Calorie-Restricted DASH Diet in Obese Older Adults.

Objective: To examine the response of a calorie-restricted Dietary Approaches to Stop Hypertension diet on indicators of cardiometabolic health in a cohort of sedentary obese older adults.Design: This was a controlled-feeding trial with a parallel design. Each participant consumed either 3 oz (85 g; n = 15) or 6 oz (170.1 g; n = 13) of lean fresh beef within a standardized calorie-restricted DASH-like diet for 12-weeks. Fasted blood samples were collected and used to measure conventional biomarkers of cardiovascular, metabolic and inflammatory health.Participants: Caucasian older (70.8 years), obese (BMI: 32 ± 6.9 kg/m2; WC: 101 ± 16.4 cm) females (n = 17) and males (n = 11) from the rural community of Brookings, South Dakota.Results: 28 participants completed the 12-week feeding trial, with no differences (p > 0.05) among the biomarkers of cardiometabolic health between the 3 and 6 oz beef intake groups. However, when the beef intake groups were combined, all biomarkers changed concentration in response to the intervention diet. Total cholesterol (p < 0.001), LDL-C (p = 0.004), HDL-C (p < 0.0001), insulin (p = 0.014), glucose (p = 0.008), HOMA-IR (p < 0.05), IL-12 (p < 0.001), and CRP (p = 0.006) all decreased in response to the study diet. IGF-1 (p < 0.001) and IL-8 (p = 0.005) increased in response to the intervention. Correlations among cardiometabolic biomarkers and body composition measures were observed. By study end, the decrease in insulin (R2 = 0.22; P = 0.012) and HOMA-IR (R2 = 0.22; P = 0.01) was positively correlated with the decrease in waist circumference. The increase in IGF-1 was significantly correlated with the decrease in waist circumference (R2 = 0.21; p = 0.014). The increase in IGF-1 was significantly correlated with the increase in sit-to-stand (R2 = 0.21; p = 0.016). The increase in IL-8 was significantly correlated with decreases in total cholesterol (R2 = 0.24; P = 0.008), LDL-C (R2 = 0.17; P = 0.031) and glucose (R2 = 0.44; P = 0.0001).Conclusions: These findings suggest that a DASH-like diet with restricted calories may potentially improve biomarkers of cardiometabolic health in sedentary obese older adults. These results also point to interrelationships between body composition changes and changes in cardiometabolic biomarkers. Lastly, regardless of meat intake amount, positive impacts on cardiometabolic biomarkers were observed in this cohort of older adults with an obese phenotype.

Sleep and cardiometabolic risk: a cluster analysis of actigraphy-derived sleep profiles in adults and children.

Sleep plays an important role in cardiometabolic health. Although the importance of considering sleep as a multidimensional construct is widely appreciated, studies have largely focused on individual sleep characteristics. The association between actigraphy-derived sleep profiles and cardiometabolic health in healthy adults and children has not been examined. This study used actigraphy-measured sleep data collected between February 2015 and March 2016 in the Child Health CheckPoint study. Participants wore actigraphy monitors (GENEActiv Original, Cambs, UK) on their nondominant wrist for 7 days and sleep characteristics (period, efficiency, timing, and variability) were derived from raw actigraphy data. Actigraphy-derived sleep profiles of 1,043 Australian children aged 11-12 years and 1,337 adults were determined using K-means cluster analysis. The association between cluster membership and biomarkers of cardiometabolic health (blood pressure, body mass index, apolipoproteins, glycoprotein acetyls, composite metabolic syndrome severity score) were assessed using Generalized Estimating Equations, adjusting for geographic clustering, with sex, socioeconomic status, maturity stage (age for adults, pubertal status for children), and season of data collection as covariates. Four actigraphy-derived sleep profiles were identified in both children and adults: short sleepers, late to bed, long sleepers, and overall good sleepers. The overall good sleeper pattern (characterized by adequate sleep period time, high efficiency, early bedtime, and low day-to-day variability) was associated with better cardiometabolic health in the majority of comparisons (80%). Actigraphy-derived sleep profiles are associated with cardiometabolic health in adults and children. The overall good sleeper pattern is associated with more favorable cardiometabolic health.

The Effect of Nut Consumption on Diet Quality, Cardiometabolic and Gastrointestinal Health in Children: A Systematic Review of Randomized Controlled Trials.

Tree nuts and ground nuts are nutrient-rich foods known to improve human health when consumed regularly in the diet. Past observational studies suggest that nuts improve adult and child health; however, limited randomized control trials (RCTs) have assessed the health effects of nuts in children. Using a systematic review approach, we examined the effect of nut intake on health outcomes in children aged 8–18 years. We searched PubMed, Scopus, Web of Science, EMBASE and Cochrane library to identify RCTs of interest. A total of 5783 articles were identified, 4821 were screened by title and abstract and 37 by full text resulting in four articles that met the inclusion criteria for the review. Nut consumption was between 15 and 30 g with durations of between 3 and 16 weeks. Nut consumption was shown to improve children’s diet quality (increase children’s intake of essential nutrients including fats (monounsaturated and polyunsaturated fats), protein and fiber), there were inconsistent effects on biomarkers of cardiometabolic health (improve lipid profiles, microvascular reactivity and inflammation) and gastrointestinal health (increase in the proportion of beneficial fecal bacteria). Further studies exploring the broad health benefits of nuts in children are needed with consideration given to higher doses and longer intervention periods.

The Acute Effect of Meal Timing on the Gut Microbiome and the Cardiometabolic Health of the Host: A Crossover Randomized Control Trial

Purpose: The interaction of diet with gut microbiome has been implicated in the onset of cardiovascular disease. The gut microbiome displays diurnal rhythms, which may be influenced by meal timing. Objective: This study aimed to investigate the effect of the timing of main meal consumption on the microbiome and cardiometabolic biomarkers of the host. Methods: Seventeen healthy adults randomly consumed an isocaloric diet for 7 days, twice, by alternating lunch with dinner meals, and with a 2-week washout in-between. Sixty percent of the participants’ daily energy requirements was consumed either as lunch or dinner, respectively. Meals were provided free to the participants. All fecal samples produced the last 3 days of each intervention were collected and analyzed for microbial profiling (16S rRNA gene amplicon sequencing), quantitative estimation of representative bacterial groups (qPCR) of the gut microbiome, and the output of short-chain fatty acids (SCFA) in feces. Fasted blood samples were analyzed for low-grade inflammatory biomarkers, blood lipids, insulin, and glucose levels. Cumulative energy loss in feces was measured over the collection period using bomb calorimetry. Results: Meal timing had no significant effects on fecal SCFA output, energy loss in feces, microbial community profiling, and bacterial species relative abundance. The absolute concentration of Escherichia coli was significantly higher after the large lunch intervention (p = 0.02). No effects on blood biomarkers of cardiometabolic health were observed. Conclusions: In a well-controlled study, main meal timing displayed minimal acute effects on the gut microbiome composition, its diet-related function, and blood biomarkers of cardiometabolic health.

A life-time of hazardous drinking and harm to health among older adults: findings from the Whitehall II prospective cohort study.

AimsTo investigate associations of life‐time hazardous and binge drinking with biomarkers of cardiometabolic health, liver function, cardiovascular disease (CVD) and mortality.DesignProspective cohort study with median follow‐up time to CVD incidence of 4.5 years.SettingLondon, UK: civil servants within the Whitehall II Study.ParticipantsA total of 4820 drinkers aged 59–83 years with biological measurements during the 2011–12 survey.MeasurementsHazardous drinking was defined as having an AUDIT‐C score ≥ 5 calculated at each decade of life, forming the following groups: never hazardous drinker, former early (stopping before age 50), former later (stopping after age 50), current hazardous drinker and consistent hazardous drinker (hazardous drinker at each decade of life).FindingsMore than half the sample had been hazardous drinkers at some point during their life‐time, comprising former early (< age 50) (19%), former later (≥ age 50) (11%), current (21%) and consistent hazardous drinker (AUDIT‐C ≥ 5 across life (5%). After adjusting for covariates, waist circumference was larger with more persistent hazardous drinking (e.g. compared with never hazardous drinkers, former early had increased waist circumference by 1.17 cm [95% confidence interval (CI) = 0.25‐2.08]; former later by 1.88 cm (CI = 0.77–2.98); current by 2.44 cm (CI = 1.50–3.34) and consistent hazardous drinker by 3.85 cm (CI = 2.23–5.47). Current hazardous drinkers had higher systolic blood pressure (2.44 mmHg, CI = 1.19–3.68) and fatty liver index scores (4.05 mmHg, CI = 2.92–5.18) than never hazardous drinkers. Current hazardous drinkers [hazard ratio (HR) = 2.75, CI = 1.44–5.22) had an elevated risk of stroke, and former later hazardous drinkers had an elevated risk of non‐CVD mortality (HR = 1.93, CI = 1.19–3.14) than never hazardous drinkers. Life‐time binge drinking was associated with larger waist circumferences and poorer liver function compared with never binge drinkers.ConclusionHazardous drinking may increase cardiometabolic risk factors; this is made worse by persistent hazardous drinking throughout life, particularly in relation to weight gain, suggesting benefits of early intervention.

HYPERTRIGLYCERIDEMIA, INFLAMMATION, HYPERCHOLESTEROLEMIA, AND FUTURE CARDIOMETABOLIC DISEASE RISK: A DATA DRIVEN CLUSTER ANALYSIS IN THE WOMEN's HEALTH STUDY

Plasma biomarkers of cardiometabolic health are invaluable tools for cardiovascular disease (CVD) and type 2 diabetes (T2D) risk stratification. Data driven patient classification may offer unbiased insights into dominant biologic risk factors that determine avenues for risk reduction. We conducted

An almond-enriched diet improves biomarkers of cardiometabolic health and increases alertness without changing cognitive performance in older overweight adults

AbstractLongitudinal studies report that regular nut consumption is associated with reduced risk of coronary heart disease and better cognitive function. Thus, nuts may improve cardiovascular and neurocognitive health – especially in ‘at-risk’ populations (e.g. overweight/obese). This study examined the effect of supplementing habitual diets of overweight/obese individuals for 12 weeks with either almonds or carbohydrate rich (CHO-rich) snack foods on biomarkers of cardiovascular and metabolic health, mood and cognitive performance. Participants (n = 151; overweight/obese, 50–80 years) were randomised to replace 15% energy intake with either almonds (Almond) or isocaloric CHO-rich snack foods (Comparator). Body weight, blood lipids, glucose, insulin, blood pressure (BP), arterial stiffness, mood and cognitive performance (memory, executive function, speed of processing) were measured at baseline and 12 weeks. One hundred and twenty eight participants (78F:50M, n = 63 almond, n = 65 control) completed the intervention (M ± SD: age 64 ± 8years, BMI 30.3 ± 3.6kg/m2, stable medication use: 32% BP and 19% lipid lowering). Compared with the CHO-rich comparator foods, there were a number of significant improvements associated with almond consumption. These included reduced serum triglycerides (M ± SEM, almond: 1.30 ± 0.062 to 1.16 ± 0.062 mmol/L vs CHO-rich 1.13 ± 0.061 to 1.17 ± 0.061 mmol/L, p = 0.005 whole population). In those with cholesterol below the ATPIII cut point of &lt; 6.2mmol/L (84% of sample), almond consumption reduced total cholesterol (almond: 5.12 ± 0.13 to 4.93 ± 0.12 mmol/L vs CHO-rich 5.24 ± 0.13 to 5.21 ± 0.11 mmol/L, p &lt; 0.001) and LDL-cholesterol (almond: 3.03 ± 0.11 to 2.87 ± 0.11 mmol/L vs CHO-rich 2.98 ± 0.10 to 3.07 ± 0.10 mmol/L, p = 0.002).). Additionally in a non-BP medicated subgroup only (n = 87, 68% of sample), there was a reduction in systolic BP (almond: 130.73 ± 2.19 to 127.02 ± 2.19 mmHg vs control:128.63 ± 2.32 to 129.48 ± 2.32mmHg, p = 0.035; and improved self-rated alertness (almond 54.73 ± 2.32 to 58.64 ± 2.32 vs CHO-rich 61.75 ± 2.28 to 61.13 ± 2.28, p = 0.048). The inclusion of almonds in the diet has the ability to improve aspects of cardiometabolic health and mood in overweight/obese adults. The lack of change in cognitive performance may reflect the fact that the study population was cognitively high performing at baseline. Future research should be directed at examining the effects of this relatively simple, cost-effective nutritional intervention in populations at greater risk of cardiometabolic and cognitive decline.

The effect of home-based low-volume, high-intensity interval training on cardiorespiratory fitness, body composition and cardiometabolic health in women of normal body mass and those with overweight or obesity: protocol for a randomized controlled trial

BackgroundThere is a high prevalence of women in South Africa with overweight and obesity which is associated with an increased risk of cardiometabolic disorders. Perceived barriers such as lack of time and motivation reduce engagement in beneficial activity behaviours for health. High-intensity interval training (HIIT) is a time-efficient and effective way to improve cardiometabolic risk profile regardless of a loss in body mass or change in body composition. This randomized controlled trial aims to determine the effects on cardiorespiratory fitness, body composition and cardiometabolic health and feasibility of a home-based 14-week HIIT program in women with overweight/obesity or normal body mass.MethodsOne hundred and twenty women (18–40 years old) with a body mass index between 20 and 35 kg/m2, will be stratified according to their BMI (normal, BMI 20–24.9 kg/m2; or high BMI ≥25 kg/m2) and randomized into a HIIT exercising group (HIIT) or a non-exercising control group (CON). HIIT participants will perform exercises for 11 min/session six times per week for a period of 14 weeks. The 2 × 4 HIIT protocol will require a work phase of own-body weight exercise lasting 2 minutes (85% VO2peak), repeated four times and separated by a one-minute active rest phase (65% VO2peak). CON participants will be asked to maintain their normal habitual lifestyle. Outcomes of cardiorespiratory fitness, body composition, echocardiography, central blood pressure, arterial stiffness and biomarkers of cardiometabolic health will be measured before and after the 14-week intervention. Every 4 weeks during the intervention, an objective estimation of compliance to the study protocol will be assessed by measuring participant physical activity over 7 days using an Actigraph GT3X accelerometer.DiscussionSupervised laboratory-based HIIT interventions are effective in improving cardiometabolic health. More pragmatic exercise protocols may however show to be successful for mitigating barriers to the engagement in physical activity and exercise resulting in positive benefits to health. Investigation into home-based HIIT regimens are important in women, where globally the rising trend of overweight and obesity overshadows that of men. The results from this study may therefore inform future research on effective exercise prescription for women’s health.Trial registrationPan African Clinical Trial Registry (www.pactr.org - id no: PACTR201806003434299), 6th June 2018.

Per- and polyfluoroalkyl substance concentrations during pregnancy and post-pregnancy biomarkers of cardiometabolic health in Project Viva

OPS 20: Chemicals, biomarkers, omics, Room 110, Floor 1, August 27, 2019, 4:30 PM - 5:30 PM Background/Aim: Per- and polyfluoroalkyl substances (PFAS) are persistent chemicals linked to weight gain and type 2 diabetes. We tested whether PFAS concentrations during pregnancy are associated with postpartum biomarkers of cardiometabolic disease. Methods: We studied 1,631 women recruited 1999-2002 in the Project Viva cohort with pregnancy (median 9.7 weeks, range 4.8-21.4) plasma measurements of 6 PFAS, including perfluorooctanesulfonic acid (PFOS), perfluorooctanoic acid (PFOA), and 2-(N-ethyl-perfluorooctane sulfonamide) acetic acid (Et-PFOSA-AcOH). PFAS were log2-transformed. At 3 years post-pregnancy we measured anthropometry and, in a subset, serum biomarkers including sex hormone binding globulin (SHBG), interleukin-6 (IL-6), and hemoglobin A1c (HbA1c). We excluded women who were pregnant within the last 6 months (n=193); the analysis sample was n=831 after loss to follow-up. We used multivariable regression, adjusting for age, pre-pregnancy body mass index, marital status, race/ethnicity, education, income, smoking, and parity. We multiply imputed missing covariates and adjusted for loss to follow-up using inverse probability of censoring weights. Results: PFAS exposure was associated with greater triceps skinfold thickness (0.69 [95%CI: 0.10, 1.28] mm per doubling in PFOS and 0.72 [95%CI: 0.06, 1.38] mm per doubling of PFOA) and greater subscapular skinfold thickness (0.53 [95%CI: -0.03, 1.09] mm per doubling in PFOS and 0.42 [95%CI: 0.02, 0.82] mm per doubling of Et-PFOSA-AcOH). PFAS were also associated with greater mid-upper arm circumference (0.27 [95%CI: -0.01, 0.54] cm per doubling of PFOA and 0.18 [95%CI: -0.01, 0.36] cm per doubling of Et-PFOSA-AcOH) and greater waist circumference (0.55 [95%CI: 0.06, 1.05] cm per doubling in Et-PFOSA-AcOH). Finally, each doubling of Et-PFOSA-AcOH was associated with lower log-SHBG (-0.06 mg/L [95%CI: -0.11, -0.00]), higher log-IL-6 (0.11 pg/mL [95%CI: 0.04, 0.18]) and higher HbA1c (0.030% [95%CI: 0.01, 0.05]). Conclusions: Though effect sizes are small, the direction of associations taken together suggests PFAS exposure is associated with an unfavorable cardiometabolic profile.

Interindividual variability and individual responses to exercise training in adolescents with obesity.

This study investigated the impact of exercise training on interindividual variability and response rates in body composition and cardiometabolic outcomes in adolescents with obesity. Postpubertal males and females (n = 143) were randomly assigned to 6 months of a diet-only control or aerobic, resistance, or combined exercise training. Body composition indices were percentages of body fat mass and lean body mass and waist circumference. Biomarkers of cardiometabolic health were systolic blood pressure and plasma fasting glucose, triglycerides, and high-density lipoprotein cholesterol. Interindividual variability was examined by comparing the standard deviation of individual responses (SDIR) to a smallest robust change (SRC). The typical error of measurement was used to classify responses. SDIR exceeded the SRC for percent body fat mass in all exercise groups (SRC = 1.04%; aerobic SDIR = 1.50%; resistance SDIR = 1.22%; combined SDIR = 2.29%), percent lean body mass (SRC = 1.38%; SDIR = 3.2%,), systolic blood pressure (SRC = 2.06 mm Hg; SDIR = 4.92 mm Hg) in the resistance group, and waist circumference (SRC = 2.33 cm; SDIR = 4.09 cm), and fasting glucose (SRC = 0.08 mmol/L; SDIR = 0.28 mmol/L) in the combined group. However, half of the reported variables (11/21) did not have a positive SDIR. Importantly, adverse response rates were significantly lower in all 3 exercise groups compared with control for body composition. Although exercise had a small influence on interindividual variability for indices of body composition, the rate of adverse responses did not increase for any outcome. Novelty Interindividual variability and individual responses to exercise training have not been investigated in adolescents with obesity. Six months of exercise training does not increase interindividual variability in adolescents with obesity. Exercise created a positive, uniform shift in responses.

Caucasian and south Asian men show equivalent improvements in surrogate biomarkers of cardiovascular and metabolic health following 6-weeks of supervised resistance training

Background: The South Asian population have greater cardiovascular risk than their age-matched Caucasian counterparts, characterized by unfavorable biomarkers. South Asians may also be partially resistant to the pleiotropic benefits of physical activity on cardiovascular health. There is a current absence of studies that compare markers of cardio-metabolic health between Caucasians and South Asians employing resistance exercise. This study set out to compare the response in biomarkers of cardio-metabolic health in Caucasians and South Asians in response to resistance exercise.Methods: Caucasian (n=15, 25.5 ± 4.8 yrs) and South Asian (n=13, 25.4 ± 7.0 yrs) males completed a 6-week progressive resistance exercise protocol. Fasting blood glucose, insulin, and their product insulin resistance (HOMA-IR), triglycerides (TRIGS), low density lipoprotein (LDL), high density lipoprotein (HDL), total cholesterol (TC), vascular endothelial growth factor (VEGF), asymmetric dimythylarginine (ADMA), L-arginine (L-ARG) and C-reactive protein (CRP) were established at baseline and following resistance exercise.Results: There were significant improvements in fasting glucose, TC, LDL, HDL and VEGF in both groups following resistance exercise (p&lt;0.05, for all). No change was observed in insulin, HOMA-IR, TRIGS, ADMA, L-ARG following resistance exercise (p&gt;0.05, in both groups). CRP increased in the South Asian group (p&lt;0.05) but not the Caucasian group (p&gt;0.05)Conclusions: The cardio-metabolic response to resistance exercise is comparable in young Caucasian and South Asian males though inflammatory response to exercise may be prolonged in South Asians.

Caucasian and south Asian men show equivalent improvements in surrogate biomarkers of cardiovascular and metabolic health following 6-weeks of supervised resistance training

Background: The South Asian population have greater cardiovascular risk than their age-matched Caucasian counterparts, characterized by unfavorable biomarkers. South Asians may also be partially resistant to the pleiotropic benefits of physical activity on cardiovascular health. There is a current absence of studies that compare markers of cardio-metabolic health between Caucasians and South Asians employing resistance exercise. This study set out to compare the response in biomarkers of cardio-metabolic health in Caucasians and South Asians in response to resistance exercise. Methods: Caucasian (n=15, 25.5 ± 4.8 yrs) and South Asian (n=13, 25.4 ± 7.0 yrs) males completed a 6-week progressive resistance exercise protocol. Fasting blood glucose, insulin, and their product insulin resistance (HOMA-IR), triglycerides (TRIGS), low density lipoprotein (LDL), high density lipoprotein (HDL), total cholesterol (TC), vascular endothelial growth factor (VEGF), asymmetric dimythylarginine (ADMA), L-arginine (L-ARG) and C-reactive protein (CRP) were established at baseline and following resistance exercise. Results: There were significant improvements in fasting glucose, TC, LDL, HDL and VEGF in both groups following resistance exercise ( p<0.05, for all). No change was observed in insulin, HOMA-IR, TRIGS, ADMA, L-ARG following resistance exercise ( p>0.05, in both groups). CRP increased in the South Asian group ( p<0.05) but not the Caucasian group ( p>0.05) Conclusions: The cardio-metabolic response to resistance exercise is comparable in young Caucasian and South Asian males though inflammatory response to exercise may be prolonged in South Asians.

Changing views in cardiometabolic disease

Metabolism Branched-chain amino acids (BCAAs) are a subset of essential amino acids that are acquired from the diet. In a Perspective, White and Newgard discuss the evidence linking increased circulating BCAAs with obesity-associated conditions, including type 2 diabetes and cardiovascular diseases. The authors discuss how BCAAs can provide biomarkers of cardiometabolic health and also the mechanisms by which BCAAs promote phenotypes of cardiometabolic disease. Science , this issue p. [582][1] [1]: /lookup/doi/10.1126/science.aav0558

The effect of a programme to improve men's sedentary time and physical activity: The European Fans in Training (EuroFIT) randomised controlled trial.

BackgroundReducing sitting time as well as increasing physical activity in inactive people is beneficial for their health. This paper investigates the effectiveness of the European Fans in Training (EuroFIT) programme to improve physical activity and sedentary time in male football fans, delivered through the professional football setting.Methods and findingsA total of 1,113 men aged 30–65 with self-reported body mass index (BMI) ≥27 kg/m2 took part in a randomised controlled trial in 15 professional football clubs in England, the Netherlands, Norway, and Portugal. Recruitment was between September 19, 2015, and February 2, 2016. Participants consented to study procedures and provided usable activity monitor baseline data. They were randomised, stratified by club, to either the EuroFIT intervention or a 12-month waiting list comparison group. Follow-up measurement was post-programme and 12 months after baseline. EuroFIT is a 12-week, group-based programme delivered by coaches in football club stadia in 12 weekly 90-minute sessions. Weekly sessions aimed to improve physical activity, sedentary time, and diet and maintain changes long term. A pocket-worn device (SitFIT) allowed self-monitoring of sedentary time and daily steps, and a game-based app (MatchFIT) encouraged between-session social support. Primary outcome (objectively measured sedentary time and physical activity) measurements were obtained for 83% and 85% of intervention and comparison participants. Intention-to-treat analyses showed a baseline-adjusted mean difference in sedentary time at 12 months of −1.6 minutes/day (97.5% confidence interval [CI], −14.3–11.0; p = 0.77) and in step counts of 678 steps/day (97.5% CI, 309–1.048; p < 0.001) in favor of the intervention. There were significant improvements in diet, weight, well-being, self-esteem, vitality, and biomarkers of cardiometabolic health in favor of the intervention group, but not in quality of life. There was a 0.95 probability of EuroFIT being cost-effective compared with the comparison group if society is willing to pay £1.50 per extra step/day, a maximum probability of 0.61 if society is willing to pay £1,800 per minute less sedentary time/day, and 0.13 probability if society is willing to pay £30,000 per quality-adjusted life-year (QALY). It was not possible to blind participants to group allocation. Men attracted to the programme already had quite high levels of physical activity at baseline (8,372 steps/day), which may have limited room for improvement. Although participants came from across the socioeconomic spectrum, a majority were well educated and in paid work. There was an increase in recent injuries and in upper and lower joint pain scores post-programme. In addition, although the five-level EuroQoL questionnaire (EQ-5D-5L) is now the preferred measure for cost-effectiveness analyses across Europe, baseline scores were high (0.93), suggesting a ceiling effect for QALYs.ConclusionParticipation in EuroFIT led to improvements in physical activity, diet, body weight, and biomarkers of cardiometabolic health, but not in sedentary time at 12 months. Within-trial analysis suggests it is not cost-effective in the short term for QALYs due to a ceiling effect in quality of life. Nevertheless, decision-makers may consider the incremental cost for increase in steps worth the investment.Trial registrationInternational Standard Randomised Controlled Trials, ISRCTN-81935608.

Higher-protein intake and physical activity are associated with healthier body composition and cardiometabolic health in Hispanic adults

Higher protein (HP) intake and physical activity (PA) have been associated with improved lean soft tissue (LST) and reduced fat mass (FM). Puerto Ricans have among the highest age-adjusted prevalence (42.5%) of obesity, which may be associated with inadequate protein consumption and PA. We examined the relationship between protein intake and PA with body composition and biomarkers of cardiometabolic health in Puerto Rican adults. Participants included 959 Puerto Rican adults (71.4% women, 28.6% men) from the Boston Puerto Rican Health Study (BPRHS), aged 46-79y (Women: age, 60.4±7.6y, BMI, 32.9±6.8 kg/m2; Men: age, 59.8±7.9y, BMI, 30.1±5.2 kg/m2). Protein intake was assessed using a food frequency questionnaire and expressed as g/kg body weight/day in energy intake-adjusted equal cut point tertile categories (lower, moderate, higher: LP<0.91g/kg/d, MP≥0.91≤1.11g/kg/d, and HP>1.11g/kg/d). PA was assessed by questionnaire and expressed in tertile categories (low, moderate and high; PA1: <0.8km/d, PA2: ≥0.8≤3.2km/d, PA3: >3.2km/d). Participants with energy-adjusted HP had lower appendicular LST (ALST: 16.2±3.8kg), LST (39.7±8.0kg) and FM (25.6±8.1kg) when compared to LP (ALST: 20.1±4.5kg; LST: 49.5±10.0kg; FM: 40.8±12.3kg; P<0.001) and MP (ALST: 18.2±4.3kg; LST: 44.1±8.8kg; FM: 32.2±9.8kg; P<0.001). However, when adjusted for total body weight (kg), relative LST was significantly greater in HP (58±9%) when compared to LP (53±9%; P<0.001) and MP (56±9%; P<0.001). Participants in PA3 had greater ALST (19.5±5.4kg), and LST (58±10%), compared to PA1 (ALST: 17.2±4.3kg; LST: 53±9%; P<0.001) or PA2 (ALST: 17.7±4.7kg; LST: 56±9%; P<0.05). Those in HP+PA3 or MP+PA2 had lower c-reactive protein (CRP; HP+PA3: 5.1±6.8mg/L; MP+PA2: 6.4±10.0mg/L), when compared to LP+PA1 (8.7±8.8mg/L; P<0.05). Insulin concentration was lower for those in both the HP and PA3 (HP+PA3; 11.4±7.9IU/mL) compared to those in both the LP and PA1 (LP+PA1; 20.7±16.3 UI/mL) (P<0.001). The highest tertiles of energy-adjusted protein intake (≥1.11g/kg/d) and PA (>3.2km/d) were associated with more desirable indicators of overall body composition and cardiometabolic health, when adjusted for body weight, than those in the lower protein intake and PA in Puerto Rican adults.

Influence of daily fresh pear consumption on biomarkers of cardiometabolic health in middle-aged/older adults with metabolic syndrome: a randomized controlled trial

Previous research suggests potential for fresh pears as a functional food for promoting cardiometabolic health. The purpose of this randomized, open-label, placebo-controlled, crossover clinical trial was to evaluate the influence of daily fresh pear consumption on blood pressure (primary outcome) and other biomarkers of cardiometabolic health in middle-aged/older adults with metabolic syndrome (MetS). Forty men and women aged 45-65 years with MetS were included and randomly assigned to receive either two medium-sized fresh pears (Pear) or a calorie-matched control drink (Control) per day for each 12-week treatment period, each separated by a 4-week washout period. After 12 weeks of daily fresh pear consumption, systolic blood pressure tended to be reduced (130 ± 2 mmHg vs. 134 ± 2 mmHg at baseline, P = 0.07) and pulse pressure was significantly reduced (51 ± 1 vs. 54 ± 1 at baseline, P < 0.05). At 12 weeks, leptin concentrations were lower in the Pear group than Control (52.5 [7.6, 120.5] ng dL-1vs. 53.4 [5.0, 120.5] ng dL-1, respectively, P < 0.05), and there was a significant group by time interaction (P < 0.05). Leptin concentrations were significantly reduced at 12 weeks compared to baseline in the Pear group (52.5 [7.6, 120.5] ng dL-1vs. 54.8 [6.4, 120.5] ng dL-1 at baseline, P < 0.05) but not in the Control group. Waist circumference was significantly reduced at 12 weeks in the Pear group (107.7 ± 2.0 cm vs. 108.4 ± 2 cm at baseline, P < 0.05) with a trend for a group by time interaction (P < 0.1), and significantly lower in the Pear group than Control (108.1 ± 2.0 cm vs. 108.8 ± 2 cm, P < 0.05) at 6 weeks with a significant group by time interaction (P < 0.05). Conversely, values were significantly increased at 6 weeks (108.8 ± 2 cm vs. 108.3 ± 2.0 cm at baseline, P < 0.05) in the Control group and sustained at 12 weeks. Waist-to-hip ratio was significantly reduced (0.92 ± 0.01 vs. 0.93 ± 0.01 at baseline, P < 0.05) at 12 weeks in the Pear group, and significantly lower than Control at 6 weeks (0.93 ± 0.01 vs. 0.93 ± 0.01, respectively, P < 0.05) and 12 weeks (0.92 ± 0.01 vs. 0.93 ± 0.01, P < 0.05). These findings suggest that daily fresh pear consumption may promote modest improvements in cardiometabolic health in middle-aged/older adults with MetS. This trial was registered at clinicaltrials.gov as NCT02228837.

Discrimination in health care and biomarkers of cardiometabolic risk in U.S. adults

IntroductionDiscrimination in health care settings is associated with poor health outcomes and may be especially harmful to older adults who are more likely to have existing risk factors or medical conditions that require on-going care. The purpose of this study is to investigate the associations between patient-reported health care discrimination and biomarkers of cardiometabolic risk. MethodsWe used 2008–2014 data from the Health and Retirement Study, a nationally representative study of US adults ages 50+ (n=12,695 participants contributing up to 16,179 observations) to examine the association between patient-reported experiences of health care discrimination and biomarkers of cardiometabolic risk: high sensitivity C-reactive protein (CRP), Hemoglobin A1c (HbAlc), high-density lipoprotein (HDL), total cholesterol, cystatin C and blood pressure and whether relationships were modified by race/ethnicity (non-Hispanic White, non-Hispanic Black, or Hispanic) or gender. We fit generalized estimating equation (GEE) models specifying a binomial distribution and logit link to account for dependency of repeated measures on individuals. ResultsHealth care discrimination was associated with higher odds of CRP>3 mg/L (OR: 1.20 (95% CI: 1.10, 1.30) and HbA1c>6.5% (OR: 1.23 (95% CI: 1.10, 1.38) but not associated with other biomarkers of cardiometabolic health in the sample as a whole. However, subgroup differences were detected. While health care discrimination was positively associated with elevated HbA1c for non-Hispanics, it was inversely associated with HbA1c for Hispanics. ConclusionsHealth care discrimination was associated with increased cardiometabolic risk based on selected biomarkers.