Cardiometabolic Disease Risk Factors Research Articles

Air pollution combined with high-fat feeding aggravates metabolic and cardiovascular diseases: A dangerous, oxidative, and immune-inflammatory association

Obesity and particulate air pollutant (PM2.5) are important risk factors for cardiometabolic diseases. PM2.5 exacerbates insulin resistance and lipid ectopic deposition in obese animals. The inorganic fraction of PM2.5, the Residual Oil Fly Ash (ROFA), is related to cardiovascular events, by enhancing the generation of reactive species, inflammatory cytokines, and leukocyte activation. However, the synergistic effects of ROFA and a high-fat diet (HFD) are still poorly described, and the studies were mainly conducted with males. AimsTo investigate if ROFA could potentiate the cardiometabolic effects of diet-induced obesity in female rats. Material and methodsWistar female rats were divided into four groups: Control (n = 6), Polluted (n = 6), HFD (n = 6), and HFD + Polluted (n = 6). HFD and HFD + Polluted received a high-fat diet (HFD) (58.3 % as fats), whilst Control and Polluted groups received a standard diet (Nuvilab CR-1). In addition, Polluted and HFD + Polluted groups received intranasal instillation of ROFA (250 μg/50 μL), while Control and HFD groups received saline solution (50 μL) daily, five days per week. Both interventions occurred 24 weeks after the animals were euthanized. Key findingsHFD combined with ROFA exposure impaired lipid profile challenged systemic and cardiac antioxidant defense, and presented a synergistic effect in inducing an immune-inflammatory condition. We found that the lipid profile disturbance is associated with HFD-induced hepatic, but not cardiac, deposition of triglycerides in female animals. SignificanceOur results support the hypothesis that ROFA exposure combined with bad feeding can exacerbate metabolic and cardiovascular diseases.

Abstract TP215: Prenatal Alcohol Exposure Impairs Long-term Behavioral Recovery Following Ischemic Stroke In Sprague Dawley Rats

Background and Purpose: Early life adversity is an important risk factor for cardiometabolic diseases in adulthood. There is very little information on prenatal insults and adult stroke outcomes. The present study tested the hypothesis that prenatal alcohol exposure (PAE) impedes long-term recovery from ischemic stroke in rats. Methods: Pregnant Sprague Dawley rats (in-house bred) were exposed to 10% alcohol or air, for 1 hour from gestational day 8 through 18 using the rodent alcohol inhalation system. Adult offspring (5-6 mo old) were subjected to endothelin-1 induced MCAo and outcomes were evaluated after 180 days. Long-term cognitive outcomes were determined using the Barnes maze and fear conditioning/extinction test. Results: In the Barnes maze test, control males showed shorter latency to reach the goal box over 3-day learning period (p=0.002), as assessed by the slope of the curve (-27.66, significantly different from 0; p=0.005). In contrast, the latency over the 3-day learning period did not improve in PAE males (-9.674, not significantly different from 0; p=0.22). In females, the latency to escape box during the learning trials was not different between the control and PAE. The fear conditioning data indicate that percent freezing over trials was similar in control and PAE-males. However, the PAE females exhibited a diminished freezing response as compared to control females (p=0.01). In the context of fear extinction, control males showed a reduction in freezing response to repeated tones over the trial blocks (p=0.004) compared to PAE-males. The control and PAE females showed similar freezing responses with repeated tones. Conclusions: The present findings support the hypothesis that PAE modifies long-term cognitive changes after stroke, and further show that different cognitive domains are affected by PAE in males and females.

Obesity, Hypertension, and Kidney Dysfunction: Mechanical Links

Abstract: Obesity is a risk factor for many diseases, including cardiovascular disease (CVD), gastrointestinal disorders, type 2 diabetes (T2DM), joint and muscle disorders, respiratory problems, and psychological problems that can significantly affect daily life. Hypertension affects more than a quarter of the adult population in developed countries, constituting an important health problem. In addition, its pathogenesis is not yet fully understood. Although hypertension is mostly seen in overweight and obese people, it is usually more difficult to control in obese people. It is well known that obesity is associated with the activation of both the sympathetic nervous system and the renin-angiotensin system, contributing to hypertension. Kidney dysfunction caused by obesity is a potential risk factor for cardiometabolic diseases, but the underlying mechanism remains unclear. The purpose of this review study is to investigate the mechanical links between obesity, hypertension, and kidney dysfunction.

Causes of Clonal Hematopoiesis: a Review.

Clonal hematopoiesis (CH) is an age-dependent process detectable using advanced sequencing technologies and is associated with multiple adverse health outcomes including cardiovascular disease and cancer. The purpose of this review is to summarize known causes of CH mutations and to identify key areas and considerations for future research on CH. Studies have identified multiple potential causes of CH mutations including smoking, cancer therapies, cardiometabolic disease, inflammation, and germline risk factors. Additionally, large-scale studies have facilitated the identification of gene-specific effects of CH mutation risk factors that may have unique downstream health implications. For example, cancer therapies and sources of environmental radiation appear to cause CH through their impact on DNA damage repair genes. There is a growing body of evidence defining risk factors for CH mutations. Standardization in the identification of CH mutations may have important implications for future research. Additional studies in underrepresented populations and their diverse environmental exposures are needed to facilitate broad public health impact of the study of CH mutations.

Scoping review protocol of multicomponent interventions to address cardiometabolic disease risk among Pacific Islander children.

Multicomponent interventions can reduce cardiometabolic disease (CMD) risk factors in childhood; however, little synthesis of the literature has taken place in the Pacific region. Pacific Islanders experience a disproportionately high prevalence of CMD risk factors, yet interventions have been slow to reach many communities. We present this protocol for a scoping review to identify and summarize existing multicomponent interventions to address CMD risk in Pacific Islander children. Eligible interventions will (1) address CMD risk factors (including but not limited to obesity, hyperglycemia, dyslipidemia, elevated blood pressure, and/or health behaviors) in 2-to-12-year-old Pacific Islander children, and (2) be multi-component (including at least two lifestyle/behavior change strategies to address CMD risk factors). To investigate existing interventions for adaptation and potential use in Pacific Islander communities, we will search Scopus, MEDLINE ALL (Ovid), EMBASE (Ovid), Yale-licensed Web of Science Core Collection, Cochrane Library, CINAHL (EBSCOhost), ProQuest Dissertations & Theses Global, Global Health (EBSCO), non-indexed Pacific journals, grey literature, government reports, and clinical trial registrations. The Joanna Briggs Institute Manual for Evidence Synthesis and the Preferred Reporting Items for Scoping Reviews will guide data extraction, evidence mapping, synthesis, and reporting of information including study population, intervention components, behavioral changes, health and implementation outcomes, theoretical frameworks, and evaluation measures. Formal ethical approval is not required. The dissemination strategy will include peer-reviewed journal publications and presentations. Synthesis of existing multicomponent interventions for Pacific Islander children will help to identify best practices that could be replicated, adapted, or combined.

Association between Shift Work Schedules and Cardiovascular Events in a Multi-Ethnic Cohort.

Shift work is known to increase the risk of cardiometabolic diseases and mortality. We investigate the relationship between shift work schedules and cardiometabolic risk factors (smoking, hypertension, and obesity) and their association with cardiometabolic diseases (diabetes and cardiovascular diseases) in a multi-ethnic population from Singapore. 2469 participants from the Singapore-based Multi-Ethnic Cohort underwent physical and clinical assessments. Shift work schedules (morning, evening, night, and mixed) were assessed using a validated questionnaire. Among shift workers, night shift workers had a significantly higher prevalence of smoking (54.5%), diabetes (27.3%), and cardiovascular events (14.1%). Compared to non-shift workers, workers in the night (OR = 2.10, 95%CI: 1.26-3.41) and mixed (OR = 1.74, 95%CI: 1.22-2.48) shift groups were more likely to be current smokers. A significant association between shift duration and smoking (OR = 1.02, 95%CI: 1.00-1.03) was also observed, with longer shift duration (in years) leading to an increase in smoking behavior. No significant associations were found between shift work schedules and hypertension, obesity (BMI), diabetes, and cardiovascular disease, as well as other cardiometabolic risk factors and diseases. This study found that shift schedules and shift duration were most strongly associated with smoking status after covariate adjustments (age, gender, ethnicity, socioeconomic status, and work arrangement), with night and mixed shift types being strongly associated with current smoker status. As smoking is a modifiable risk factor for cardiometabolic disease, employers of shift workers should increase work-based health interventions to control smoking and promote a healthier workforce.

Association between obesity indicators and cardiometabolic disease in Chinese adults.

Obesity is an established risk factor for cardiometabolic disease. Different measurements of obesity with cardiometabolic disease have been compared in recent studies in Western countries. However, obesity-related criteria for the Chinese population differ from the standard World Health Organization guidelines, and similar research in Chinese adults is limited. Data were obtained from a comprehensive intervention project involving a community population with cardiovascular and cerebrovascular risk factors in Shenzhen in 2015. A total of 4,000 participants (1,605 men and 2,395 women) with a mean age of 56.01±9.78 years were included in this study. Categorical data are reported as percentages, and continuous data are reported as mean ± standard deviation. Logistic regression analyses were conducted to examine the associations of body mass index (BMI), waist circumference (WC), and neck circumference (NC) with hypertension, diabetes, and dyslipidemia among Chinese adults. The participants had a mean BMI of 24.25±3.33 kg/m2, mean NC of 33.59±4.16 cm, and mean WC of 82.44±9.84 cm (men: 85.46±9.10 cm, women: 80.40±9.81 cm). Blood pressure, plasma glucose, and lipid levels in the BMI, WC, and NC groups were statistically significant (p < 0.05). BMI, WC, and NC were positively correlated with systolic blood pressure, diastolic blood pressure, fasting plasma glucose, total cholesterol, and triglyceride and negatively correlated with low-density lipoprotein cholesterol (p < 0.05), while the risk of hypertension, diabetes, and dyslipidemia increased with an increase in BMI, WC, and NC (p < 0.05). One SD of BMI, WC, and NC resulted in an increase of 41%, 22%, and 31% risk of hypertension; 45%, 34%, and 47% risk of diabetes; and 37%, 32%, and 23% risk of dyslipidemia, respectively. Compared to BMI and NC, WC was more strongly associated with cardiometabolic diseases in Chinese adults.

Potential Involvement of LncRNAs in Cardiometabolic Diseases.

Characterized by cardiovascular disease and diabetes, cardiometabolic diseases are a major cause of mortality around the world. As such, there is an urgent need to understand the pathogenesis of cardiometabolic diseases. Increasing evidence suggests that most of the mammalian genome are transcribed as RNA, but only a few percent of them encode for proteins. All of the RNAs that do not encode for proteins are collectively called non-protein-coding RNAs (ncRNAs). Among these ncRNAs, long ncRNAs (lncRNAs) are considered as missing keys to understand the pathogeneses of various diseases, including cardiometabolic diseases. Given the increased interest in lncRNAs, in this study, we will summarize the latest trend in the lncRNA research from the perspective of cardiometabolism and disease by focusing on the major risk factors of cardiometabolic diseases: obesity, cholesterol, diabetes, and hypertension. Because genetic inheritance is unavoidable in cardiometabolic diseases, we paid special attention to the genetic factors of lncRNAs that may influence cardiometabolic diseases.

Screen Time from Adolescence to Adulthood and Cardiometabolic Disease: a Prospective Cohort Study

BackgroundPrevious studies have analyzed the relationship between screen time and cardiometabolic disease risk factors among adolescents, but few have examined the longitudinal effects of screen time on cardiometabolic health into adulthood using nationally representative data.ObjectiveTo determine prospective associations between screen time and later cardiometabolic disease over a 24-year period using a nationally representative adolescent cohort.DesignLongitudinal prospective cohort data from the National Longitudinal Study of Adolescent to Adult Health (Add Health) collected from 1994 to 2018.ParticipantsAdolescents aged 11–18 years old at baseline (1994–1995) followed for 24 years.Main MeasuresPredictors: screen time (five repeated measures of self-reported television and video watching from adolescence to adulthood). Outcomes: Five repeated measures of body mass index (BMI); two repeated measures of waist circumference, hypertension, hyperlipidemia, and diabetes collected at 15- and 24-year follow-up exams.Key ResultsFor the 7105 adolescents in the sample (49.7% female, 35.0% non-white), the baseline adolescent average screen time per day was 2.86 ± 0.08 hours per day, which generally declined through 24-year follow-up. Average BMI at baseline was 22.57 ± 0.13 kg/m2, which increased to 30.27 ± 0.18 kg/m2 through follow-up. By 24-year follow-up, 43.4% of participants had obesity, 8.4% had diabetes, 31.8% had hypertension, and 14.9% had hyperlipidemia. In mixed-effects generalized linear models, each additional hour of screen time per day was associated with 0.06 (95% CI 0.04–0.09) within-person increase in BMI. Each additional hour of screen time per day was associated with higher within-person odds of high waist circumference (AOR 1.17, 95% CI 1.09–1.26), obesity (AOR 1.09, 95% CI 1.03–1.15), and diabetes (AOR 1.17, 95% CI 1.07–1.28). Screen time was not significantly associated with hypertension or hyperlipidemia.ConclusionsIn this prospective cohort study, higher screen time in adolescence was associated with higher odds of select indicators of cardiometabolic disease in adulthood.

Fresh Beef and Lamb Consumption in Relation to Nutrient Intakes and Markers of Nutrition and Health Status among the Population Aged 5-90 Years in Ireland.

The dietary role of meat is under scrutiny for health and environmental reasons, yet a growing body of evidence proposes that advice to limit red meat consumption is unnecessarily restrictive. The aim of this study was to investigate the role of 'fresh beef and lamb' in the diet of the population (5-90 years) in Ireland and its association with markers of nutrition and health status. Analyses are based on data from three nationally representative dietary surveys in the Republic of Ireland. Dietary intake data were estimated using food records, and nutrient intakes were estimated based on UK and Irish food composition tables. Biochemical samples were collected and analysed using standard procedures. 'Fresh beef and lamb' (defined as beef/lamb that had not undergone any preserving process other than chilling/freezing/quick-freezing) was consumed by 68-84% of the population and intakes ranged from 19 to 43 g/d across age groups. It made important contributions to intakes of protein, monounsaturated fat, vitamins D, B12, niacin, iron and zinc while also contributing relatively small proportions of total fat, saturated fat and salt. Higher consumption of 'fresh beef and lamb' was associated with higher intakes of protein, niacin, vitamins B6, B12, zinc and potassium (but also total fat) and lower intakes of carbohydrate and total sugars (but also dietary fibre). In adults, older adults and WCBA, higher consumption of 'fresh beef and lamb' was not associated with increased risk factors of cardio-metabolic diseases nor was it associated with better or poorer nutritional status for vitamins D, B12 or iron. This study adds to the evidence base on the contribution of 'fresh beef and lamb' in the diet and may be useful to policymakers updating guidance for healthy diets from sustainable food systems.

Language Preference and its Moderating Role in Coping with Stress: The Hispanic Community Health Study/Study of Latinos.

Stress and stressful events are widely accepted risk factors for cardiometabolic diseases, including coronary heart disease and diabetes. As language plays a seminal role in development and regulation of emotions and appraisals of stressful situations, it may contribute to documented differences in the stress-cardiometabolic disease association across ethnic groups. We investigated associations between language preferences (Spanish vs English) and downstream health consequences of stress. Using data from the Sociocultural Ancillary Study of the Hispanic Community Health Study/Study of Latinos, we assessed the relationship between reported stress and risk factors (alcohol use, smoking, body mass index, depressive symptoms) and prevalence of self-reported (coronary heart disease, stroke, chronic obstructive pulmonary disease [COPD]) and clinically assessed chronic conditions (diabetes, hypertension) among 5154 Hispanic/Latino adults living in the US. Factor analysis was used to calculate a composite stress variable from participants' self-reported chronic stress, perceived stress, and adverse childhood experiences. Sampling weights and survey methodology were integrated in all analyses to account for this study's complex survey design. After controlling for sociodemographic factors (Hispanic/Latino background, study site, years in the US, social acculturation, education, income, age, sex), higher composite stress scores were associated with elevated risk factors and greater prevalence of coronary heart disease, diabetes, and COPD. Furthermore, the relationship between stress and COPD was significantly stronger among Hispanic/Latino adults who preferred to be interviewed in Spanish (compared to English). Stronger connections between stress and likelihood of drinking alcohol among English-preferring persons also emerged. These results are interpreted in light of the Hispanic health paradox and the role of cultural processes in the development of health risk factors and chronic conditions. Our findings can be integrated into relevant approaches to address health disparities within and across Hispanic/Latino populations in the US.

S-49-1: NUTRITION, CARDIO-METABOLIC RISK AND THE METABOLOME

Dietary and nutritional factors are known to be important in the emergence and progression of cardiometabolic disease risk factors including high blood pressure and obesity. At population level, large variations in cardiometabolic and cardiovascular disease risk across populations and temporal variations within populations point to the key importance of lifestyle factors including diet in the occurrence of these diseases. For example, epidemiological studies (including INTERSALT and INTERMAP studies), animal models and randomised controlled clinical trials (including the recent Salt Substitute and Stroke Study (SSaSS) in rural China [1]) have demonstrated the importance of salt intake in raised blood pressure and the rise of blood pressure with age, with interventions to lower salt intake resulting in lower risk of stroke, heart disease and all-cause mortality. The “exposome“ concept has been proposed as a means to encapsulate the effects of environmental and lifestyle exposures (including diet) on the individual’s metabolism and risk of disease. The concept is that these factors interact at a cellular and systems level (against a background of genetic susceptibility) to determine the trajectory of health or disease. Their associated molecular signatures can be captured using omic technologies -- with the measurement of small molecule metabolites in blood or urine (metabolomics) being the most proximal to the phenotype. Metabolomics captures at high-resolution the biological signatures from the totality of internal (biochemical) and external exposures, including nutritional exposures and interactions between diet and the gut microbiome. These represent the end products of metabolic pathways associated with a wide range of physiological and pathophysiological processes, as well as direct signatures of lifestyle exposures including dietary intakes [2]. Agnostic (untargeted) analyses through the metabolome-wide association study (MWAS) applied to large-scale epidemiological data, coupled with targeted measurement of specific metabolites, can reveal novel signatures of perturbations in metabolic and disease pathways associated with nutritional exposures, including those related to blood pressure and adiposity. Development of nutritional biomarkers using such approaches could lead to objective markers of dietary intakes and diet quality which may be important for developing and monitoring dietary goals for long-term health.

The Associations between Accelerometer-measured Physical Activity and Cardiometabolic Disease Risk Factors and Metabolic Syndrome in Korean Adults : Results from 2014-2016 KNHANES DATA

PURPOSE This study aimed to examine the associations between accelerometer-measured physical activity and both cardiometabolic disease risk factors and metabolic syndrome in Korean adults. METHODS We performed a retrospective cohort study with age-sex matched case-control using data from the 2014-2016 Korea National Health and Nutrition Examination Survey, which was administered to South Korean adults (n=320). Individuals were categorized into quartiles based on accelerometer-measured moderate-to-vigorous physical activity (MVPA). Demographic and physical characteristics, waist circumference, visceral adiposity index, blood pressure, lipid profiles, and TG/HDL-C were observed. The associations between MVPA status and cardiometabolic disease risk factors as well as metabolic syndrome were determined using multiple logistic regression. RESULTS For the waist circumference, SBP, DBP, MBP, visceral adiposity, triglyceride, and a surrogate estimate of insulin resistance, the Q1 and Q2 groups had higher means compared with the Q3 and Q4 groups. HDL-C was higher in the Q3 and Q4 groups compared to the Q1 and Q2 groups. Odds ratios for cardiometabolic disease risk factors and metabolic syndrome decreased in a curvilinear manner with the increasing quartile of MVPA. CONCLUSIONS Adults with higher MVPA participation were strongly associated with cardiometabolic disease risk factors and metabolic syndrome.

Cardiometabolic Traits in Adult Twins: Heritability and BMI Impact with Age.

Background: The prevalence of obesity and cardiometabolic diseases continues to rise globally and obesity is a significant risk factor for cardiometabolic diseases. However, to our knowledge, evidence of the relative roles of genes and the environment underlying obesity and cardiometabolic disease traits and the correlations between them are still lacking, as is how they change with age. Method: Data were obtained from the Chinese National Twin Registry (CNTR). A total of 1421 twin pairs were included. Univariate structural equation models (SEMs) were performed to evaluate the heritability of BMI and cardiometabolic traits, which included blood hemoglobin A1c (HbA1c), fasting blood glucose (FBG), systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), triglycerides (TGs), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C). Bivariate SEMs were used to assess the genetic/environmental correlations between them. The study population was divided into three groups for analysis: ≤50, 51−60, and >60 years old to assess the changes in heritability and genetic/environmental correlations with ageing. Results: Univariate SEMs showed a high heritability of BMI (72%) and cardiometabolic traits, which ranged from 30% (HbA1c) to 69% (HDL-C). With age increasing, the heritability of all phenotypes has different degrees of declining trends. Among these, BMI, SBP, and DBP presented significant monotonous declining trends. The bivariate SEMs indicated that BMI correlated with all cardiometabolic traits. The genetic correlations were estimated to range from 0.14 (BMI and LDL-C) to 0.39 (BMI and DBP), while the environmental correlations ranged from 0.13 (BMI and TC/LDL-C) to 0.31 (BMI and TG). The genetic contributions underlying the correlations between BMI and SBP and DBP, TC, TG, and HDL-C showed a progressive decrease as age groups increased. In contrast, environmental correlations displayed a significant increasing trend for HbA1c, SBP, and DBP. Conclusions: The findings suggest that genetic and environmental factors have essential effects on BMI and all cardiometabolic traits. However, as age groups increased, genetic influences presented varying degrees of decrement for BMI and most cardiometabolic traits, suggesting the increasing importance of environments. Genetic factors played a consistently larger role than environmental factors in the phenotypic correlations between BMI and cardiometabolic traits. Nevertheless, the relative magnitudes of genetic and environmental factors may change over time.

Elevated serum leptin levels are associated with lower renal function among middle-aged and elderly adults in Taiwan, a community-based, cross-sectional study.

Plasma leptin is considered a risk factor for obesity and cardio-metabolic disease, but the link between serum leptin and renal function is still under evaluation. In our study, we focused on the relationship between serum leptin and renal function, and we investigated the relationship in more detail. The 396 middle-aged and elderly Taiwanese adults recruited for our health survey were the subject of our research. All participants agreed to participate and signed a consent form before they joined and completed our study. We divided the participants into three groups according to eGFR tertiles and analyzed the parameters between each group. Then, we used Pearson's correlation test to investigate the relationship between eGFR levels and cardio-metabolic risk factors with adjustment for age. The scatter plot indicates the trend between serum leptin levels and eGFR levels. Participants were reclassified into three subgroups according to their leptin levels and the bar chart reveals the prevalence of chronic kidney disease (CKD) in each group. Finally, we used multivariate linear regression to evaluate the relationship between serum leptin and eGFR levels with adjustment for age, sex, smoking status, drinking status, body mass index (BMI), uric acid levels, hypertension (HTN), diabetes mellitus (DM), and dyslipidemia. In our study, we analyzed the data from 396 eligible participants. A total of 41.4% of the participants were male, and the average age of all participants was 64.81 years ( ± 8.78). The participants in the high eGFR group were more likely to have lower serum leptin levels. Furthermore, eGFR values were negatively correlated with serum leptin levels even after adjustment for age. The prevalence of CKD in the high serum leptin group was higher than that in the low serum leptin group. Serum leptin levels showed significant negative correlations with eGFR levels (β=-0.14, p<0.01) in the multivariate linear regression after adjusting for age, sex, smoking status, drinking status, BMI, uric acid levels, HTN, DM, and dyslipidemia. According to our study, serum leptin levels show a negative relationship with eGFR levels in middle-aged and elderly people in Taiwan. In addition, high serum leptin levels could be an novel marker to survey kidney failure in clinical practices.

Unhealthy Food and Beverage Consumption during Childhood and Risk of Cardiometabolic Disease: A Systematic Review of Prospective Cohort Studies

BackgroundGlobal consumption of unhealthy foods, including ultra-processed foods (UPFs) and sugar-sweetened beverages (SSBs), has increased substantially among pediatric populations. Suboptimal diet during early life can track into adulthood, alongside risk factors for cardiometabolic disease. ObjectiveTo inform the development of updated WHO guiding principles for complementary feeding of infants and young children, this systematic review sought to examine the association between unhealthy food consumption during childhood and cardiometabolic risk biomarkers. MethodsPubMed (Medline), EMBASE, and Cochrane CENTRAL were systematically searched, with no language restriction, up to 10 March 2022. Inclusion criteria were randomized controlled trials (RCTs), non-RCTs, and longitudinal cohort studies; children aged ≤10.9 y at exposure; studies reporting greater consumption of unhealthy foods and beverages (defined using nutrient- and food-based approaches) than no or low consumption; studies assessing critical nonanthropometric cardiometabolic disease risk outcomes (blood lipid profile, glycemic control, or blood pressure). ResultsOf 30,021 identified citations, 11 articles from 8 longitudinal cohort studies were included. Six studies focused on exposure to unhealthy foods or UPF, and 4 focused on SSB only. Methodological heterogeneity was too high across studies to meta-analyze effect estimates. A narrative synthesis of quantitative data revealed that exposure to unhealthy foods and beverages, specifically NOVA-defined UPF, in children of preschool age may be associated with a worse blood lipid and blood pressure profile in later childhood (Grading of Recommendations Assessment, Development, and Evaluation [GRADE]: low and very low certainty, respectively). No associations were evident between SSB consumption and blood lipids, glycemic control, or blood pressure (GRADE: all low certainty). ConclusionsNo definitive conclusion can be made because of quality of the data. More high-quality studies that purposefully assess the effects of unhealthy food and beverage exposure during childhood on cardiometabolic risk outcomes are needed. This protocol was registered at https://www.crd.york.ac.uk/PROSPERO/ as CRD42020218109.

SKELETAL MUSCLE ADIPOSITY IS ASSOCIATED WITH LOWER COGNITION IN AFRICAN CARIBBEAN WOMEN

Abstract Objective Skeletal muscle adiposity (SMA) increases with aging and is recognized as a major risk factor for cardiometabolic diseases, disability, and mortality among older adults. Obesity is related to dementia and cognitive decline yet the relationship between SMA and cognition remains ill defined. The objective of this study was to assess SMA and cognitive function among African Caribbean women.Design and Methods Cross-sectional analysis of 448 African Caribbean women in the Tobago Health Study (mean age, 55 years; range, 39-84 years). Cognition was assessed by the Digit Symbol Substitution Test (DSST), a test of information processing speed with a range of 0-90; higher scores suggest better cognitive function (faster information processing speed). Calf SMA (muscle density) was assessed with computed tomography (Stratec XCT-2000). Linear regression was used to assess the association of SMA with DSST adjusted for age, education, muscle area, waist circumference, alcohol intake, smoking, physical activity, diabetes, and hypertension. Results Participants had a BMI of 30.7 kg/m2. Mean (SD) DSST scores and SMA were 39.2 (13.1) and 71.7 (5.3) mg/cm3, respectively. After full adjustment, we found that one SD greater skeletal muscle adiposity was associated with a 1.40 lower DSST score (p-value=0.025). Conclusions Our findings suggest that in African Caribbean women, greater SMA is associated with slower information processing speed, an early indicator of future dementia risk. Future studies using an expanded battery of cognitive tests and longitudinal follow-up should further advance our understanding of the role of SMA and dementia risk among African ancestry populations.

Effect of adiposity and physical fitness on cardiometabolic risk factors in adolescents: A 2-year longitudinal study.

Although risk factors for cardiometabolic diseases begin to present in young people, the association between physical fitness and adiposity with traditional and novel risk factors for cardiometabolic diseases across adolescence remains relatively unknown. Following ethical approval, fifty-two adolescents (age 11.6 ± 0.6 years; 32 girls) were recruited for a 2-years longitudinal study. Adiposity was assessed based on sum of skinfolds, waist circumference and body mass index, and physical fitness as distance run on the multi-stage fitness test (MSFT). Risk factors for cardiometabolic diseases (pro- and anti-inflammatory cytokines, plasma insulin, Homeostatic Model Assessment of Insulin Resistance - HOMA-IR, blood pressure) were measured following an overnight fast. Relationships between independent and response variables were analysed using multi-level modelling (final combined models were created using the stepwise backward elimination method). Plasma insulin concentration and HOMA-IR were positively associated with adiposity and inversely associated with distance run on the MSFT (all p < 0.05). The final combined models for plasma insulin concentration and HOMA-IR contained main effects for age, skinfolds and distance run on the MSFT. Levels of the anti-inflammatory cytokine IL-10 were inversely related to the sum of skinfolds (p = 0.046), whereas there was a trend for levels of the pro-inflammatory cytokine TNF-α to be positively related to the sum of skinfolds (p = 0.056). Adiposity and physical fitness are important, independent, determinants of metabolic health in adolescents. Furthermore, adiposity influences levels of pro- and anti-inflammatory cytokines in adolescence, with greater adiposity associated with a poorer inflammatory profile. The present study demonstrates an independent effect of physical fitness on metabolic health longitudinally across adolescence. It is therefore recommended that future work develops therapeutic interventions that reduce adiposity and enhance physical fitness in adolescents, to promote lifelong health.

A nutritional supplement based on a synbiotic combination of Bacillus subtilis DSM 32315 and L-alanyl-L-glutamine improves glucose metabolism in healthy prediabetic subjects - A real-life post-marketing study.

Impaired glucose homeostasis is a significant risk factor for cardiometabolic diseases, whereas the efficacy of available standard therapies is limited, mainly because of poor adherence. This post-marketing study assessed the glucose-lowering potential of a synbiotic-based formulation. One hundred ninety-two participants were enrolled in a digital nutrition program with continuous glucose monitoring (CGM) and received a study product comprising Bacillus subtilis DSM 32315 and L-alanyl-L-glutamine. Participants underwent a first sensor phase without supplementation, followed by a 14-day supplementation phase without sensor, and completed by a second sensor phase while continuing supplementation. Fasting glucose levels were determined before and after supplementation by CGM. In addition, the postprandial glycemic response to an oral glucose challenge, body weight, HbA1c concentrations, and BMI was analyzed. Subgroup analyses of subjects with elevated glucose and HbA1c levels vs. normoglycemic subjects were performed. Supplementation with the study product resulted in significant improvements in glucose parameters (delta values: fasting glucose -2,13% ± 8.86; iAUC0-120 -4.91% ± 78.87; HbA1c: -1.20% ± 4.72) accompanied by a significant weight reduction (-1.07 kg ± 2.30) in the study population. Subgroup analyses revealed that the improvements were mainly attributed to a prediabetic subgroup with elevated fasting glucose and HbA1c values before supplementation (delta values: fasting glucose -6.10% 4± 7.89; iAUC0-120 -6.28% ± 115.85; HbA1c -3.31% ± 4.36; weight: -1.47 kg ± 2.82). This study indicates that the synbiotic composition is an effective and convenient approach to counteract hyperglycemia. Further placebo-controlled studies are warranted to test its efficacy in the treatment of cardiometabolic diseases.

Associations between evening shift work, irregular sleep timing, and gestational diabetes in the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-be (nuMoM2b).

Shift work is a risk factor for cardiometabolic disease, possibly through effects on sleep-wake rhythms. We hypothesized that evening (afternoon and night combined) and irregular (irregular/on-call or rotating combined) shift work during pregnancy is associated with increased odds of preeclampsia, preterm birth, and gestational diabetes mellitus (GDM), mediated by irregular sleep timing. The Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-be (nuMoM2b) is a prospective cohort study (n = 10 038) designed to investigate risk factors for adverse pregnancy outcomes. Medical outcomes were determined with medical record abstraction and/or questionnaires; sleep midpoint was measured in a subset of participants with ≥5-day wrist actigraphy (ActiWatch). We estimated the association of evening and irregular shift work during pregnancy with preeclampsia, preterm birth, and GDM using logistic regression, adjusted for adversity (cumulative variable for poverty, education, health insurance, and partner status), smoking, self-reported race/ethnicity, and age. Finally, we explored whether the association between shiftwork and GDM was mediated by variability in sleep timing. Evening shift work is associated with approximately 75% increased odds of developing GDM (adjusted OR = 1.75, 95% CI: 1.12-2.66); we did not observe associations with irregular shifts, preterm birth, or preeclampsia after adjustment. Pregnant evening shift workers were found to have approximately 45 minutes greater variability in sleep timing compared to day workers (p < .005); sleep-timing variability explained 25% of the association between evening shift work and GDM in a mediation analysis. Evening shift work was associated with GDM, and this relationship may be mediated by variability in sleep timing.