Cardiometabolic Health Indicators Research Articles

Placental 11β-HSD2 and Cardiometabolic Health Indicators in Infancy.

Fetal excessive exposure to glucocorticoids may program cardiometabolic risk. Placental 11 β-hydroxysteroid dehydrogenase 2 (11β-HSD2) serves as a barrier to prevent fetal overexposure to maternal glucocorticoids. It has not been explored whether placental 11β-HSD2 levels are associated with cardiometabolic health in postnatal life. In a prospective birth cohort study of 246 mother-infant pairs, we measured placental 11β-HSD2 expression and maternal (32-35 weeks of gestation) and cord plasma cortisol concentrations. The primary outcomes were HOMA of insulin resistance (IR) and blood pressure (BP) in infants at age 1 year. Other outcomes included fasting insulin, HOMA β-cell function, carotid intima-media thickness, weight z score, and skinfold thickness (triceps and subscapular) at age 1 year. Placental 11β-HSD2 expression was negatively correlated with HOMA-IR (r = -0.17, P = 0.021) and fasting insulin (r = -0.18, P = 0.017) and marginally negatively correlated with systolic BP (r = -0.16, P = 0.057) but was not correlated with HOMA of β-cell function, diastolic BP, carotid intima-media thickness, and skinfold thickness (all P > 0.1) in infants at age 1 year. Cord plasma cortisol was negatively correlated to skinfold thickness (r = -0.20, P = 0007) but was not correlated with other outcomes at age 1 year. Maternal plasma cortisol was positively correlated with maximal carotid intima-media thickness (r = 0.20, P = 0.03) but was not correlated with other outcomes. Adjusting for maternal and infant characteristics, the associations were similar. The study is the first to show that higher placental 11β-HSD2 expression is associated with lower IR in infancy. Independent cohort studies are required to confirm this novel finding.

Health and saliva microbiomes of a semi-urbanized indigenous tribe in Peninsular Malaysia

Background: The indigenous people of Peninsular Malaysia, also known as Orang Asli, have gradually been urbanized. A shift towards non-communicable diseases commonly associated with sedentary lifestyles have been reported in many tribes. This study engaged with a semi-urbanized Temiar tribe from Kampong Pos Piah, Perak, who are experiencing an epidemiological transition. Methods: Weight, height, waist circumference, blood pressure, HbA1C and lipid levels were measured as indicators of cardio-metabolic health. DNA was extracted from saliva using salting-out method followed by PCR amplification of the V3-V4 region of the 16S rRNA gene and sequencing on Illumina MiSeq. Microbiome analysis was conducted on Qiime v1.9. Statistical analysis was conducted using Qiime v1.9 and R. Results: The study revealed that 60.4% of the Temiar community were overweight/obese, with a higher prevalence among women. HbA1C levels showed that 45% of Temiar had pre-diabetes. Insulin resistance was identified in 21% of Temiar by using a surrogate marker, TG/HDL. In total, 56.5% of Temiar were pre-hypertensive, and the condition was prevalent across all age-groups. The saliva microbiome profiles of Temiar revealed significant differences by gender, BMI, abdominal obesity as well as smoking status. The relative abundance of Bifidobacterium, bacteria commonly found in dairy products, was increased in men. Prevotella, associated with consumption of plant-rich diets, was increased in women. Mogibacteriacea and Mycoplasma levels were significantly elevated in overweight individuals. Proteobacteria was significantly depleted in smokers. Conclusions: Temiar from Pos Piah had a high prevalence of cardio-metabolic risks, including general and abdominal obesity, pre-diabetes, prehypertension and hypertension. This phenomenon has not been previously reported in this tribe. The saliva microbiome profiles were significantly different for individuals of different gender, BMI scores and abdominal obesity and smoking status.

Impact of 5-week high-intensity interval training on indices of cardio metabolic health in men

PurposeTo compare the acute and chronic effects of high-intensity intermittent training (HIIT) and moderate-intensity continuous training (MICT) on indices of cardio-metabolic health: (HDL-c, total cholesterol, triglycerides, heart ratio, and phase angle/PhA) in physically active men. MethodsTwenty active men were randomly allocated to HIIT (n = 10), or MICT (n = 10) for 5 weeks, three times per week. HIIT consisted of running 5 km with 1-min at 100% of maximal aerobic speed interspersed by 1-min passive recovery while subjects in MICT group ran continuously the same 5 km at 70% of maximal aerobic speed. Blood samples were collected at different moments during the first and last exercise session. Before and after 5 weeks of both exercise training protocols, heart ratio (during exercise session) and PhA were measured pre and post-exercise training. ResultsFasting HDL-c levels did not change after 5 weeks of HIIT or MICT. Perceptual variation of HDL pre and post training (fed state) tended to differ between HIIT and MICT (p = 0.09). All lipoproteins parameters (HDL-c, total cholesterol, triglycerides and non-HDL) were increased in post-acute exercise session compared to pre-exercise during the first and last training session, these being observed after both training protocols. PhA and heart rate measured at different times during the first and last training session were not affected in both training protocols. ConclusionThese results indicate that HIIT and MICT modify the post-exercise lipoprotein profile acutely. On the other hand, only HIIT tended to increase HDL-c levels chronically.

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.

Dairy food intake, diet patterns, and health: Findings from the Maine-Syracuse Longitudinal Study

This study compared the intake of yogurt and other dairy foods in relation to other dietary habits, and associations with cardiovascular health indicators. Comparative analyses of dietary intakes and cardiometabolic health indicators were conducted in participants from the Maine-Syracuse Longitudinal Study, conducted in 2001-2006 (n = 699). Participants (10.2% of sample) who consumed yogurt more frequently (≥ 5 serves per week) also consumed more fruit, vegetables, nuts, and fish, but fewer sweets, sugar-sweetened soft drinks, and alcohol. The yogurt-healthy food score was significantly inversely associated with fasting plasma glucose (p = 0.044), waist circumference (p = 0.004), and smoking (p = 0.004), and significantly positively associated with physical activity (p < 0.001). In addition, the yogurt-healthy food score was associated with protection against MetS abdominal obesity (OR: 0.80, 95% CI: 0.66-0.07, p = 0.02). The yogurt-healthy dietary pattern was significantly associated with a better cardiometabolic profile.

BMI is an effective indicator of cardiometabolic health, researchers say

BMI is an effective indicator of cardiometabolic health, researchers say

The Cardiometabolic Risk Profile of Underreporters of Energy Intake Differs from That of Adequate Reporters among Children at Risk of Obesity

ABSTRACTBackgroundMisreporting of energy intake (EI) in nutritional epidemiology is a concern because of information bias, and tends to occur differentially in obese compared with nonobese subjects.ObjectiveWe examined characteristics of misreporters within a cohort of children with a parental history of obesity and the bias introduced by underreporting.MethodsThe QUebec Adipose and Lifestyle InvesTigation in Youth (QUALITY) cohort included 630 Caucasian children aged 8–10 y at recruitment with ≥1 obese parent [body mass index (BMI; in kg/m2) >30 or waist circumference >102 cm (men), >88 cm (women)] and free of diabetes or severe illness. Children on antihypertensive medications or following a restricted diet were excluded. Child and parent characteristics were measured directly or by questionnaire. Three 24-h dietary recalls were administered by phone by a dietitian. Goldberg's cutoff method identified underreporters (URs). Logistic regression identified correlates of URs. We compared coefficients from linear regressions of BMI after 2 y on total EI at baseline 1) in all participants; 2) in adequate reporters (ARs) (excluding URs); 3) in all participants statistically adjusted for underreporting; 4) excluding URs using individual physical activity level (PAL)-specific cutoffs; and 5) in all participants statistically adjusted for underreporting using PAL-specific cutoffs.ResultsWe identified 175 URs based on a calculated cutoff of 1.11. URs were older, had a higher BMI z score, and had poorer cardiometabolic health indicators. Parents of URs had a lower family income and higher BMI. Child BMI z score (OR: 3.07; 95% CI: 2.38, 3.97) and age (OR: 1.46/y; 95% CI: 1.14, 1.87/y) were the strongest correlates of underreporting. The association between BMI and total EI was null in all participants but became significantly positive after excluding URs (ß = 0.62/1000 kcal; 95% CI: 0.33, 0.92/1000 kcal) and after adjustment for URs (ß = 0.85/1000 kcal; 95% CI: 0.55, 1.06/1000 kcal).ConclusionsURs in 8- to 10-y-old children differed from ARs. Underreporting biases measurement of nutritional exposures and the assessment of exposure-outcome relations. Identifying URs and using an appropriate correction method is essential.

Anthropometric measures and their association with risk factors for cardio-metabolic diseases in Kenyan adults

Background: The prevalence of cardio-metabolic diseases (CMD) is drastically increasing worldwide. Anthropometric measures of fat accumulation are correlated with CMD and Metabolic Syndrome (MS), but few studies have addressed this association in sub-Saharan African populations.Aim: To investigate the association between anthropometric features, MS and other CMD risk factors in a population from Kenya.Subjects and methods: In this cross-sectional study including 1405 Kenyans, anthropometric measurements including visceral adipose tissue (VAT) and abdominal subcutaneous adipose tissue (SAT) were carried out. Fasting blood glucose and standard oral glucose tolerance test, fasting serum insulin and plasma lipids were analysed. Homeostatic model assessment of insulin resistance was calculated. Systolic and diastolic blood pressures were measured.Results: CMD risk factors and MS were associated with all anthropometric features, except for high-density lipoprotein cholesterol levels (p < 0.05). The strongest association between MS and anthropometrics was seen with SAT (β = 1.45 ± 0.32 in men and 0.88 ± 0.14 in women, both p < 0.05).Conclusions: Anthropometric measures, especially features of central obesity such as VAT and SAT, are relevant indicators of cardio-metabolic health in Kenyan populations. SAT is the strongest predictor of MS. These results highlight the need for further research on the pathological implication of VAT and SAT, in order to understand patterns of fat distribution and cardio-metabolic health among different ethnic groups.

Reductions in whole-body fat mass but not increases in lean mass predict changes in cardiometabolic health indices with exercise training among weight-stable adults

We assessed whether body composition changes with 9 months of exercise training predicted changes in cardiometabolic health indices in weight-stable adults. We hypothesized that within ±5% weight change, changes in whole-body fat and lean masses would predict changes in cardiometabolic health indices with exercise training. Using a randomized parallel design, 152 adults (age: 49 ± 8 year; body mass index: 30.0 ± 2.7 kg/m2; mean ± SD) performed resistance exercises 2 d/wk and aerobic exercises 1 d/wk for 9 months. Participants consumed isoenergetic supplements with 0, 10, 20, or 30 g whey protein twice daily and remained weight stable within ±5% of baseline weight. Body weight and composition were measured using dual-energy x-ray absorptiometry pre- and postintervention. Multiple linear regression model was applied for data analyses. Independent of whey protein supplementation, reductions in fat mass predicted increases in high-density lipoprotein cholesterol (unstandardized beta-coefficient [β], −0.03; 95% confidence interval [CI], −0.06 to −0.01; P = .007) and insulin sensitivity index (β, −0.52; 95% CI, −0.95 to −0.09; P = .018) and decreases in waist circumference (β, 0.67; 95% CI, 0.17-1.18; P = .009). In contrast, increases in lean mass did not predict changes in any of the measured cardiometabolic health indices. Health improvements with training that emphasize resistance exercises are typically attributed to increases in lean mass; however, these results underscore reducing body fat to predict cardiometabolic health improvements.

The prospective association between objectively measured sedentary time, moderate-to-vigorous physical activity and cardiometabolic risk factors in youth: a systematic review and meta-analysis.

Sedentary time and moderate-to-vigorous physical activity (MVPA) may be uniquely related to cardiometabolic health. Excessive sedentary time is suggested as an independent cardiometabolic risk factor, while MVPA is favourably associated with cardiometabolic health. This systematic review and meta-analysis summarizes the evidence on a prospective relationship between objectively measured sedentary time, MVPA and cardiometabolic health indicators in youth. PubMed, Embase, CINAHL, PhyscINFO and SPORTDiscus were systematically searched from January 2000 until April 2018. Studies were included if sedentary time and physical activity were measured objectively and examined associations with body mass index, waist circumference, triglycerides, high-density lipoprotein, insulin, blood pressure or the clustering of these cardiometabolic risk factors. We identified 30 studies, of which 21 were of high quality. No evidence was found for an association between sedentary time and cardiometabolic outcomes. The association between MVPA and individual cardiometabolic risk factors was inconsistent. The meta-analysis for prospective studies found a small but significant effect size between MVPA at baseline and clustered cardiometabolic risk at follow-up (ES -0.014 [95% CI, -0.024 to -0.004]). We conclude that there is no prospective association between sedentary time and cardiometabolic health, while MVPA is beneficially associated with cardiometabolic health in youth.

Differential Relationship between Intermuscular Adipose Depots with Indices of Cardiometabolic Health.

Background Globally, accumulation of intermuscular adipose tissue (IMAT) is positively associated with insulin resistance. Whether this association is observed consistently in different skeletal muscles and encompasses other markers of cardiometabolic health is not well known. Objectives The purpose of this secondary analysis study was to investigate associations among thigh or calf IMAT stores and indices of cardiometabolic health in adults who are overweight and obese participating in dietary interventions. A subset of calf data was analyzed to assess relations between IMAT in the gastrocnemius (type II fiber predominance) and soleus (type I fiber predominance) with markers of cardiometabolic health. Materials and Methods Thigh and calf compositions were assessed via magnetic resonance imaging in 113 subjects (mean ± SD, age: 50 ± 16 y (range: 21–77 y), BMI: 31 ± 3 kg/m2), 103 of which completed dietary interventions with or without energy restriction-induced weight loss. A subset of data (n = 37) was analyzed for relations between muscle compartments (gastrocnemius and soleus) and cardiometabolic health. IMAT was regressed separately against fasting serum glucose concentrations, insulin, homeostatic model assessment-insulin resistance (HOMA-IR), and lipids and lipoproteins. Results In general, total thigh IMAT was predictive of markers of glucose control, while total calf IMAT was not. Specifically, baseline thigh IMAT was positively associated with fasting glucose, insulin, and HOMA-IR. IMAT content changes in any depot did not predict improvement in cardiometabolic health. Conclusions The strength of the relationship between IMAT and glucose control-related indices of cardiometabolic health is dependent on IMAT location. Specifically, greater IMAT in the thigh is a better predictor of cardiometabolic risk than greater IMAT in the calf in adults who are overweight and obese.

The Impact of Cardiac Rehabilitation on Mental and Physical Health in Patients With Atrial Fibrillation: A Matched Case-Control Study

BackgroundPatients with atrial fibrillation (AF) experience symptom burden, exercise intolerance, weight gain, poor mental health, and diminished quality of life (QoL). Cardiac rehabilitation (CR) is recommended for patients with heart disease, and its benefits are well established, yet clinical guidelines for patients with AF do not include the referral to CR. MethodsIn this matched retrospective, case-control study, we examined the impact of CR on changes in QoL, mental health, and cardiometabolic health indicators in patients with or without persistent or permanent AF. Patients attended CR that addressed risk factor management and provided support services and exercise training twice weekly for 3 months. Height, body mass, waist circumference, blood pressure, and heart rate were measured, and the Short Form-36 and Hospital Anxiety and Depression Scale were administered at baseline and 3 months follow-up. ResultsA total of 94 patients (AF, n = 47; no AF, n = 47) (aged 70 ± 8 years) participated. Significant improvements in 2 of the 8 subscales and the Physical Component Summary of the Short Form-36 were observed across groups after CR (P < 0.05). Significant interactions revealed that the effect of CR was greater for energy, emotional well-being, social functioning, pain, and the Physical Component Summary in patients without AF (P < 0.05 for each). No significant improvements in anxiety (AF: −1.3 ± 3.4; no AF: −1.3 ± 4.3), depression (AF: −1.1 ± 2.9; no AF: −0.4 ± 2.7), body mass index (AF: −0.5 ± 1.2; no AF: −0.8 ± 1.5, kg/m2), waist circumference (AF: −1.7 ± 4.6; no AF: 0.4 ± 8.1, cm), or blood pressure (AF: −2.3 ± 17.1/−3.9 ± /9.3; no AF: 1.8 ± 16.4/−0.8 ± /9.3 mm Hg) were observed across groups after CR. ConclusionsCR improved QoL to a greater extent in patients with heart disease without than with persistent or permanent AF.

Effects of a High-Protein Diet Including Whole Eggs on Muscle Composition and Indices of Cardiometabolic Health and Systemic Inflammation in Older Adults with Overweight or Obesity: A Randomized Controlled Trial.

Age-related increases in intermuscular adipose tissue (IMAT) impair muscle quality, decrease functional capacity, and promote several cardiometabolic and inflammatory disorders. Whether these age-related alterations in muscle composition improve by consuming a high-protein (HP) diet with whole eggs are unclear. This parallel-design, randomized-controlled trial assessed the effects of a 12-week eucaloric HP diet with three whole eggs per day (1.4 g protein kg−1 day−1) versus a normal-protein diet void of eggs (NP, 0.8 g protein kg−1 day−1) on muscle composition (IMAT), cardiometabolic health, and systemic inflammation in older adults with overweight or obesity (12 men and 10 women; age 70 ± 5 years, BMI 31.3 ± 3.2 kg/m2, mean ± SD). No changes in muscle composition were observed over time, independent of protein intake. Total body weight was reduced in both groups (−3.3 ± 1.2%) and lean mass was preserved only with the HP diet. LDL concentration and hip circumference decreased only with the NP diet, while MCP-1 and HsCRP concentrations increased over time in both groups. A HP diet with whole eggs promotes lean mass retention with modest weight loss, but does not positively influence muscle composition, cardiometabolic health or systemic inflammation, compared to a NP diet void of eggs.

The Cardiometabolic Burden of Self-Perceived Obesity: A Multilevel Analysis of a Nationally Representative Sample of Korean Adults

Emerging evidence has shown that self-perception of overweight/obese status is associated with unfavorable cardiometabolic outcomes, above and beyond actual body weight. Given the lack of research among Asian populations, we examined the association between weight perception and metabolic syndrome (MetS) and cardiometabolic risks among Koreans. Data from the 2010–2015 Korea National Health and Nutrition Examination Survey, including women (N = 12,181) and men (N = 9,448) aged 19–65 years, were analyzed. Weight status perception was measured by participants’ self-evaluation of their body size (“very/slightly obese,” “normal,” and “very/slightly thin”). Overall, 23.2% of women and 28.7% of men had MetS. Our cross-sectional multilevel logistic analyses showed a significant positive association between self-perceived obesity (vs. perceived normal weight) and MetS, independent of BMI and sociodemographic/behavioral/medical conditions, with a stronger association detected among men (OR = 1.38, p < 0.05) than women (OR = 1.22, p < 0.05), confirmed by a statistically significant interaction. Additionally, perceived obesity was associated with high blood pressure (OR = 1.27, p < 0.05) and high triglycerides (OR = 1.38, p < 0.05) among men and low high-density lipoprotein cholesterol (OR = 1.15, p < 0.05) among women. While further prospective research is needed, our findings suggest that perception of being obese may be an unfavorable indicator of cardiometabolic health among Koreans regardless of actual body weight.

The Acute Effects of Exercise Intensity on Blood Glucose Levels in Type 1 Diabetics

For individuals with Type 1 diabetes mellitus (T1DM), regular physical activity is a fundamental strategy in the management of glycemic control. Previous studies have shown that continuous, moderate-intensity exercise in individuals with T1DM decreases blood glucose concentrations, often resulting in hypoglycemia, whereas vigorous-intensity exercise can increase blood glucose, impacting the risk of hyperglycemia. Sprint interval training (SIT), characterized by brief, all-out bursts of supramaximal exercise, has been shown to improve indices of cardiometabolic health, despite a minimal time commitment. However, the effects of low volume SIT on individuals with T1DM is largely unknown. PURPOSE: to contrast the acute effects of exercise intensity on blood glucose levels in Type 1 diabetics. METHODS: Four recreationally active college- age students with T1DM, completed a treadmill test to determine maximal aerobic speed (MAS), and performed each of the following 20-min treadmill-based protocols: 1) Moderate-intensity continuous training (MICT): 5-min warm-up (WU), 10 minutes at 70% MAS, 5-min cool-down (CD); 2) high-intensity interval training (HIIT): 5-min WU, 1-min at 90% MAS, 1-min at 30% MAS repeated 5 times, 5-min CD; 3) SIT: 5-min WU, 30-sec at 120% MAS, 2-min, 50-sec at 30% MAS repeated 3 times, 5-min CD. Blood glucose was monitored via glucometer every 5-min during exercise and for 45-min after. RESULTS: A statistically significant decline in blood glucose was observed in both the MICT and HIIT conditions (p <0.001, respectively) but not in the SIT condition (p = 0.696). From baseline to the 45-min mark, blood glucose decreased by 27% in both the MICT (180 ± 27 to 132 ± 39) and HIIT (183 ± 29 to 132 ± 15) protocols, but only 11% in the SIT (193 ± 41 to 165 ± 70) protocol. CONCLUSIONS: The results of this study provide initial proof-of-concept that a low volume SIT protocol can maintain target blood glucose levels while exercising in individuals with T1DM.

Abstract P319: Changes in Perceptions of Neighborhood Environment and Cardiometabolic Outcomes in Two Predominantly African American Neighborhoods

Introduction: Perceived neighborhood characteristics, including neighborhood satisfaction, are associated with lower obesity rates and more favorable cardiovascular risk factor profiles. However, prior studies have not evaluated how longitudinal changes in perceived neighborhood characteristics following revitalization efforts may associate with cardiometabolic health indicators. Methods: Changes in neighborhood perception scales (infrastructure, safety, aesthetics, and satisfaction) were determined from 2013-2016 and categorized into the following groups: improvement, no change, or worsening over the time-period. Multivariate linear regression was used to measure the association between perceived improvement in each of the neighborhood characteristics with cardiometabolic outcomes (BMI, SBP, HbA1c, HDL-c) assessed in 2016. Outcomes were compared for those who perceived neighborhood improvements to those who perceived no change/worsening of neighborhood characteristics. Models were adjusted for age, sex, income, education, marital status, physical function, neighborhood, years spent in neighborhood. Interaction terms for age and sex were tested in the adjusted models. Results: Among the 622 individuals who did not move during the time-period, 93% were African American, 80% were female, and the mean age was 58 years. Many participants reported some improvements in neighborhood environment; infrastructure (48% reporting improvements), safety (47%), aesthetics (46%) and satisfaction (28%). In covariate-adjusted models, those who perceived improvement in their neighborhood aesthetics over the follow-up period had a significantly higher BMI (kg/m 2 ) than those who perceived no improvement/worsening (β=1.2, p=0.05). Similarly, perceived improvements in neighborhood safety were associated with higher BMI (β=1.5, p=0.01); however, they were also significantly associated with lower SBP (mmHg) (β=-3.8, p=0.01). A significant interaction was observed between sex and perceived improvement in safety when predicting BMI (interaction term p=0.04), such that the relationship between perceived improvements in safety and higher BMI was observed only among women (β=2.3, p=0.02). We did not observe any statistically significant interactions by age. We also did not find significant associations between changes in neighborhood characteristics and HDL-c or HbA1c. Conclusions: These findings suggest that perceived neighborhood characteristics may have differing associations with multiple cardiometabolic outcomes (BMI, SBP). This highlights the complexity of the associations between neighborhood characteristics and health as well as the importance of considering how changes in perceived neighborhood characteristics associate with multiple clinically relevant cardiometabolic risk factors, and how associations may be sex dependent.

Abstract P247: Under-reporters of Caloric Intake Have Worst Cardiometabolic Risk Profile Among Children at Risk of Obesity

Introduction: Misreporting of dietary data in nutritional epidemiology is a major concern for information bias, as they rely on subjects’ ability to accurately remember and report the foods they consumed. In children, underreporting is common and tends to occur differentially according to certain characteristics. We sought to describe characteristics of under-reporters (UR) within a cohort of children with a parental history of obesity, and to examine the bias introduced with underreporting in children. Methods: Data stem from the QUALITY cohort of 630 children, 8-10 years at recruitment with at least one obese parent. Three separate 24-hour dietary recalls were administered by a dietitian at baseline. Child and parent characteristics were obtained through direct measurement (blood pressure, blood lipids, anthropometrics) or questionnaires (socio-economic characteristics). Goldberg's cut-off method identified UR, by comparing a ratio of reported energy intake and basal metabolic rate to a calculated cut-off value. We used logistic regression to identify correlates of UR. We examined the bias resulting from underreporting by comparing the coefficients from the linear regression of BMI z-score after 2 years on glycemic load (GL) at baseline in all participants and in the adequate reporters (AR) subset, after excluding UR. Results: We identified 167 UR and 408 AR in the QUALITY cohort based on a calculated Goldberg's cut-off of 1.11. UR had a tendency to be older (9.9 vs. 9.5), had a higher BMI z-score (1.5 vs. 0.4) and had poorer cardiometabolic health indicators including higher SBP, DBP, triglycerides and LDL and lower HDL. UR had a lower family income (38,561 vs. 44,078 $CAN), parents were less educated (47.3% vs. 56.9% with a university education) and had a higher BMI compared to parents of AR. In logistic regression, age per year (OR: 1.48, 95%CI: 1.15-1.91), BMI z-score (OR: 2.04, 95% CI: 1.17-3.54), percent fat mass (OR: 1.06, 95%CI: 1.01-1.12) and family income (OR: 0.86 per 10,000$, 95%CI: 0.76-0.98) were the strongest correlates of underreporting. Linear regressions showed that the association between BMI and GL was null when all participants were included, but became significantly positive (ß=0.06 per 10 units, 95%CI: 0.05-0.07) after exclusion of the UR. Conclusion: In the QUALITY cohort, UR were different from AR. Underreporting is an important source of error in nutritional epidemiology that can bias measurement of nutritional exposures and the assessment of exposure outcome relationships. To prevent this bias, UR must be identified and an appropriate correction method must be used.

A Cluster RCT to Reduce Workers' Sitting Time: Impact on Cardiometabolic Biomarkers.

To evaluate the initial and long-term impacts on cardiometabolic health indicators of the Stand Up Victoria intervention-a 12-month, multicomponent workplace-delivered intervention that successfully reduced overall sitting time, primarily by increasing standing time. Office worksites (≥1 km apart) from a single organization were cluster randomized to intervention (n = 7) or control (n = 7). Participants were 136 intervention and 95 control desk-based workers (5-39 per worksite; 68% women; mean ± SD age = 45.6 ± 9.4 yr). Outcomes, assessed at baseline (0 months), 3, and 12 months, were 14 individual biomarkers of body composition, blood pressure, glucose metabolism, lipid metabolism, and a composite overall cardiometabolic risk score. Intervention effects were assessed by linear mixed models, accounting for repeated measures and clustering, baseline values, and potential confounders. Missing data were multiply imputed. Significance was set at P < 0.05, two-tailed. No significant intervention effects were observed at 3 months. Significant effects, favoring intervention, were observed at 12 months for fasting glucose (-0.34; 95% confidence interval [CI], -0.65 to -0.03; P = 0.028 mmol·L) and the overall cardiometabolic risk score (-0.11, 95% CI, -0.29 to -0.00; P = 0.046). Other intervention effects were typically weakly in favor of the intervention group, but were nonsignificant and estimated with wide CI. In "healthy" workers (not selected as having any specific health condition), a workplace intervention showed a small benefit for improving biomarkers of cardiometabolic risk, but only with 12 months of intervention and not for all biomarkers. Long-term facilitation of movement and standing at work may be a useful approach to reducing cardiovascular disease risk in the working population. The potential benefits for workers at high risk for cardiovascular disease (e.g., with diabetes) may be even greater and merit investigation.

Effect of an intervention in Physical Education classes on health related levels of physical fitness in youth

The aim of this study was to verify the effect of an intervention program during Physical Education (PE) classes on levels of physical fitness related to health in youth. This is a pre-experimental study. The students (40 boys and 48 girls) were conveniently selected from a private school in Southern Brazil. Cardiorespiratory fitness was assessed through the six-minute test, recorded in meters (m), flexibility through the sit-and-reach test, recorded in centimeters (cm), abdominal strength/resistance through repetitions in one minute (rep) and body mass index (BMI) through the [mass/height²] equation. The intervention program was conducted in PE classes, often twice a week, during an entire school year. Data analysis was performed using descriptive analysis, Student's t-test and repeated measures ANOVA, taking into consideration p&lt;0.05. The PE program promoted improvement in cardiorespiratory fitness for boys (pre-test: 1123.0m±197.0m; post-test: 1247.2m±139.6m; p=0.002) and girls (pre-test: 940.7m±75.0m; post-test: 1028.7m±67.3m; p=0.001); abdominal strength/resistance for boys (pre-test: 46.15rep±10.15rep; post-test: 53.90rep±10.49rep; p=0.001) and girls (pre-test: 36.39rep±8.32rep; post-test: 44.00rep±6.16rep; p=0.001); and flexibility for boys (pre-test:22.77cm±8.11cm; post-test: 27.60cm±7.23cm; p=0.006) and girls (pre-test: 32.08cm±6.21cm; post-test: 34.89cm±6.43cm; p=0.032). There weren’t changes in mean BMI values. Therefore, it’s considered that the PE program aimed at health promotion through physical fitness can improve the indicators of cardiometabolic and muscle-skeletal health in students.

Does diet mediate associations of volume and bouts of sedentary time with cardiometabolic health indicators in adolescents?

ObjectiveExamine the mediating role of diet in the relationship between volume and duration of sedentary time with cardiometabolic health in adolescents.MethodsAdolescents (12‐19 years) participating in the 2003/04 and 2005/06 U.S. National Health and Nutrition Examination Survey (NHANES) were examined. Cardiometabolic health indicators were body mass index z‐scores (zBMI) (n = 1,797) and metabolic syndrome (MetS) (n = 812). An ActiGraph hip‐worn accelerometer was used to derive total sedentary time and usual sedentary bout duration. Dietary intake was assessed using two 24‐hour dietary recalls. Mediation analyses were conducted to examine five dietary mediators [total energy intake, discretionary foods, sugar‐sweetened beverages (SSB), fruits and vegetables, and dietary quality] of the relationship between total sedentary time and usual sedentary bout duration with zBMI and MetS.ResultsTotal sedentary time was inversely associated with zBMI (β = −1.33; 95% CI −2.53 to −0.13) but attenuated after adjusting for moderate‐to‐vigorous physical activity. No significant associations were observed between usual sedentary bout duration with zBMI or either sedentary measure with MetS. None of the five dietary variables mediated any of the relationships examined.ConclusionsFurther studies are needed to explore associations of specific time periods (e.g., after school) and bout durations with both cardiometabolic health indicators and dietary behaviors.