Cardiovascular Risk Factors In Children Research Articles

The Impact of Obesity and Lifestyle Status on Cardiovascular Risk Factors in Children and Adolescents with Type 1 Diabetes (T1D)

Cardiovascular disease is more frequent in patients with T1D than the general population. The aim of the study was to examine the impact of obesity, diet and physical activity (PA) on common cardiovascular risk factors in youth with T1D. Cross-sectional analyses were performed using data from 96 T1D subjects [mean age 13.4 ± 2.7 years, (females 57%), median disease duration 5.3 (range 3.5-8.4) years]. Dietary intake was evaluated by a single 24-hour dietary recall and a food frequency questionnaire (FFQ). Diet quality was assessed with the KIDMED test. The ENERGY-child questionnaire was used for the assessment of PA. Systolic (SBP), diastolic (DBP) blood pressure, HbA1c levels and lipid profile were evaluated. The prevalence of overweight/obesity was 31%. Overweight/obese individuals were in higher SBP percentile, compared to those with normal weight (68.59 ± 26.58 vs. 51.77 ± 26.72, P = 0.006). In multiple regression analysis, higher BMI z-score, was associated with higher ηbA1c (standardized β = 0.334, P = 0.002, R2 = 0.268) and higher triglycerides (standardized β = 0.224, P = 0.05, R2 = 0.095). Most participants (80%) abstained from optimal Mediterranean Diet (MD). Lower KIDMED score was associated with higher ηbA1c (standardized β = - 0.432 P < 0.001, R2 = 0.268). Partial correlation analyses after controlling for confounding factors revealed that BMI z-score was negatively correlated with low fat dairy portions/d (r = - 0.315, P < 0.05), HbA1c was positively correlated with high fat dairy portions/d (r = 0.305, P < 0.05) and SBP percentile was negatively correlated with total milk and yogurt portions/d (r = - 0.313, P < 0.05). Moreover, higher participation in sports (hours/week), was associated with lower DBP percentile (standardized β = - 0.283, P = 0.015, R2 = 0.080). The maintenance of a healthy body weight and a physically active lifestyle, was accompanied by lower BP levels in the participants of this study. Greater adherence to MD was associated with lower HbA1c. Disclosure A. Lampousi: None. D.E. Delis: None. M. Xatzipsalti: None. A. Vazeou: None.

Association of anthropometric measures and cardiovascular risk factors in children and adolescents: Findings from the Aboriginal Birth Cohort study.

This study examined the association of anthropometric measures including height, leg length, trunk length and body mass index (BMI) at 11 and 18 years with systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol, low-density lipoprotein cholesterol (LDL-c) and high-density lipoprotein cholesterol (HDL-c) at 11 and 18 years. We analysed data from 661 participants from the Aboriginal Birth Cohort study–a longitudinal study based in the Northern Territory, Australia. Associations between anthropometric measures and cardiovascular risk factors were investigated in linear regression analyses adjusted for confounding, with imputation for missing data. In adjusted analyses, increasing leg length [males: 0.47mmHg/cm (0.23, 0.72); females: 0.50mmHg/cm (0.18, 0.83)], trunk length [males: 0.50mmHg/cm (0.28, 0.73); females: 0.57mmHg/cm (0.33, 0.81)] and height [males: 0.32mmHg/cm (0.16, 0.48); females: 0.32mmHg/cm (0.12, 0.52)] at 11 years was associated with higher SBP at 11 years. When these exposures were measured at 18 years the effect on SBP at 18 years had attenuated, and only increased trunk length was associated with higher SBP at 18 years for both sexes [males: 0.46mmHg/cm (0.05, 0.87); females: 0.69mmHg/cm (0.30, 1.08)]. We observed little association between height, leg length and trunk length and DBP, total cholesterol, LDL-c and HDL-c. Increased BMI was associated with elevated SBP and DBP at 11 and 18 years. Our findings suggest that height, leg length, and trunk length measured at 11 and 18 years was generally not associated with cardiovascular risk factors at 11 and 18 years. However, greater childhood BMI was associated with higher blood pressure and this association persisted into adolescence. This study contributes to the limited body of evidence on the association between measures of early anthropometry and cardiovascular risk among the Australian Aboriginal population.

Aerobic fitness and physical activity are inversely associated with body fat, dyslipidemia and inflammatory mediators in children and adolescents living with HIV

ABSTRACTThis study aimed to investigate if moderate to vigorous physical activity (MVPA) and aerobic fitness are associated with cardiovascular risk factors in HIV+ children and adolescents. Sixty-five children and adolescents (8 to 15 years) provided minutes of MVPA measured by accelerometers and peak oxygen uptake (peak VO2) by breath-by-breath respiratory exchange. Cardiovascular risk factors were characterized by body fat, blood pressure, total cholesterol, HDL-c, LDL-c, triglycerides, glucose, insulin, C-reactive protein (CRP), interleukin (IL)-6, tumor necrosis factor-alpha (TNF-α) and carotid intima-media thickness. Results indicated that higher MVPA was associated with lower values of total (β = −3.566) and trunk body fat (β = −3.495), total cholesterol (β = −0.112) and LDL-c (β = −0.830). Likewise, higher peak VO2 was associated with lower total (β = −0.629) and trunk body fat values (β = −0.592) and levels of CRP (β = −0.059). The physically active participants had lower total cholesterol (−24.4 mg.dL−1) and LDL-c (−20.1 mg.dL−1) compared to participants judged to be insufficiently active. Moreover, participants with satisfactory peak VO₂ showed lower total (−4.1%) and trunk (−4.3%) body fat, CRP (−2.3 mg.L−1), IL-6 (−2.4 pg.mL−1) and TNF-α (−1.0 pg.mL−1) compared to low peak VO2 peers. High levels of MVPA and aerobic fitness may prevent developing of cardiovascular risk factors in children and adolescents HIV+.

Obesity and anthropometric determinants of autonomic control in children with sleep-disordered breathing-which measurements matter?

Obesity and anthropometric measurements predict more severe sleep-disordered breathing (SDB) in children, and are associated with cardiovascular risk factors in children without SDB. We aimed to investigate whether anthropometric measurements predicted autonomic control in children with SDB. We hypothesised that anthropometric measures would be significant predictors of decreased heart rate variability. Children (3-17 years) with SDB (n = 298) and non-snoring controls (n = 126) underwent polysomnography. BMI z-score, neck, waist and hip circumference were recorded. Heart rate variability, indicating autonomic control, was analysed during wake, non-rapid eye movement stages N1, N2 and N3, and rapid eye movement (REM) sleep. The determinants of heart rate variability (low-frequency power [LF], high-frequency power [HF] and LF/HF ratio) were analysed using multiple stepwise linear regression. Independent variables were age, neck, waist and hip circumference, neck-to-waist ratio, waist-to-hip ratio and waist-to-height ratio, obstructive apnoea hypopnoea index, arousal index and SpO2 nadir. Waist and hip circumference, and waist-to-height ratio were significant negative determinants of both HF and LF power during wake, reflecting dampened autonomic control (LF: waist/height ratio, B = -1917 (95% CI: -3640, -194), p = 0.03; HF: hip circumference, B = -27, (-48, -7), p = 0.01), N1&2 (LF/HF: hip circumference, B = 0.01 (0.004, 0.024), p = 0.005) and N3 (LF: waist/height ratio, B = -2495, (-4005, -986), p = 0.001; HF, hip circumference, B = -54, (-102, -6), p = 0.03; LF/HF, waist circumference, B = 0.01, (0.004, 0.015), p = 0.002). Age was the strongest determinant of heart rate variability during wake and sleep. This study suggests that while age is a determinant of autonomic control in children with SDB, the strongest modifiable factor determining dampened autonomic control is increased central adiposity, as reflected in the waist and hip circumference and the waist-to-height ratio.

The International Childhood Cardiovascular Cohort (i3C) consortium outcomes study of childhood cardiovascular risk factors and adult cardiovascular morbidity and mortality: Design and recruitment

Although it is widely thought that childhood levels of cardiovascular (CV) risk factors are related to adult CV disease, longitudinal data directly linking the two are lacking. This paper describes the design and organization of the International Childhood Cardiovascular Cohort Consortium Outcomes Study (i3C Outcomes), the first longitudinal cohort study designed to locate adults with detailed, repeated, childhood biological, physical, and socioeconomic measurements and a harmonized database. I3C Outcomes uses a Heart Health Survey (HHS) to obtain information on adult CV endpoints, using mail, email, telephone, and clinic visits in the United States (U.S.) and Australia and a national health database in Finland. Microsoft Access, REsearch Data Capture (REDCap) (U.S.), LimeSurvey (Australia), and Medidata™ Rave data systems are used to collect, transfer and organize data. Self-reported CV events are adjudicated via hospital and doctor-released medical records. After the first two study years, participants (N = 10,968) were more likely to be female (56% vs. 48%), non-Hispanic white (90% vs. 80%), and older (10.4 ± 3.8 years vs. 9.4 ± 3.3 years) at their initial childhood study visit than the currently non-recruited cohort members. Over 48% of cohort members seen during both adulthood and childhood have been found and recruited, to date, vs. 5% of those not seen since childhood. Self-reported prevalences were 0.7% Type 1 Diabetes, 7.5% Type 2 Diabetes, 33% hypertension, and 12.8% CV event. 32% of CV events were judged to be true. I3C Outcomes is uniquely able to establish evidence-based guidelines for child health care and to clarify relations to adult CV disease.

Body Mass Index and Cardiovascular Risk Factors in Children and Adolescents with High Birth Weight

Background/Aims: This study aimed to identify a possible association among high birth weight with overweight/obesity, high arterial blood pressure, dyslipidemia, and insulin resistance in children and adolescents. Methods: This is a cross-sectional study with 719 children and adolescents (6–12 years) stratified according to birth weight (low birth weight [LBW] <2,500 g, adequate birth weight [ABW] 2,500–3,999 g, and high birth weight [HBW] ≥4,000 g). Data collected were anthropometric data, arterial blood pressure levels, lipid profile, and insulin resistance (fasting glucose and insulin, used to calculate homeostatic model assessment-IR). Results: The mean age of schoolchildren was 9.5 ± 2.0 years and 371 (51.6%) were male. LBW and HBW were observed in 79 of 719 (10.9%) and 40 of 719 (55.6%) children/adolescents, respectively. There was no increased risk of overweight (OR 0.9; 95% CI 0.4–2.1; p = 0.964) and obesity (OR 1.4; 95% CI 0.6–3.5; p = 0.588) in HBW group compared to LBW and ABW groups. HBW was not associated with high blood pressure, dyslipidemia, and insulin resistance. The LBW group was independently associated with higher values of systolic (OR 1.07; 95% CI 1.05–1.10; p < 0.01) and diastolic blood pressure (OR 1.04; 95% CI 1.00–1.07; p = 0.044). Conclusion: There was no association between HBW with overweight/obesity and classic cardiovascular risk factors in this group of children/adolescents. Only LBW was related to higher blood pressure levels.

Prevalence of cardiovascular risk factors in schoolchildren from a rural and urban area in Colombia

Introduction: Cardiovascular risk factors (CVRF) have their origin in childhood. Several studies have shown differences in the prevalence of CVRFs between rural and urban areas, probably related to lifestyle behaviors. Objective: To describe the CVRFs identified in children from a rural and urban population in Colombia. Materials and methods: A cross-sectional study was conducted between March and June 2013 in schoolchildren from an urban and a rural area in Colombia. Weight, height, blood pressure, triglycerides, fasting glucose, and total cholesterol were measured, and a survey covering nutrition, physical activity, and passive smoking was applied. The prevalence of CVRFs was calculated with a 95% CI. Results: A total of 1,055 schoolchildren (833 urban, 222 rural) participated; their mean age was 6.71 years. The prevalence of CVRFs in the rural and the urban study population, respectively, was 68.69%/90.16% for sedentary lifestyle, 97.18%/95.44% for unhealthy diet, 11.16%/14.52% for passive smoking, 0%/5.64% for obesity, 6.31%/11.28% for hypertension, 0%/0% for diabetes, and 18.28%/16.31% for total cholesterol. A total of 99.15% of the study population had at least one CVRF, with an average of 3.14 for the urban area (SD:1.12), and of 2.76 for the rural one (SD: 1.1). Overweight children had a higher prevalence of hypertension (15.21%; 95% CI:11.04%-20.59%) and sedentary lifestyle (90.69%), compared to those without this risk factor (8.98% and 84.32%, respectively). Conclusions: Our results showed a high prevalence of CVRFs in children, especially in the urban area. Public health strategies adapted to the rural and urban populations should be implemented.

Reliability and Validity of HeartSmartKids: A Survey of Cardiovascular Risk Factors in Children

IntroductionReliable and valid instruments to measure counseling effectiveness related to eating, activity, and inactivity are lacking. HeartSmartKids (HSK; HeartSmartKids, LLC, Boulder, Colorado) is a bilingual decision-support technology that can be used to assess and counsel families on cardiovascular risk factors in children. The purpose of this study was to establish preliminary test–retest reliability and convergent validity of HSK questions relative to a previously validated questionnaire, HABITS. MethodData were collected from children (ages 9-14 years) during an intervention study. A multitrait/multimethod correlation matrix framework was used to examine the test–retest reliability (n = 35) and convergent validity (n = 103) of HSK relative to HABITS. ResultsHSK had moderate/strong test–retest reliability and good convergent validity between HSK and HABITS. DiscussionThis study provides preliminary test–retest reliability and convergent validity of a useful clinical tool that can be used to quickly assess children's nutrition (e.g., fruit/vegetable consumption, snacks, sugar-sweetened beverages, breakfast) and activity habits to guide behavior change counseling. Additional work should be done validating HSK with objective measures.

Increased ApoB/ApoA1 ratio is associated with excess weight, body adiposity, and altered lipid profile in children

ObjectiveTo investigate ApoB/ApoA1 ratio and its association with cardiovascular risk factors in children. MethodsCross-sectional study with 258 children aged 8 and 9 years old, enrolled in all urban schools in the city of Viçosa-MG. Anthropometric and body composition assessment, as well as biochemical profile of the children was performed. Socioeconomic variables and sedentary lifestyle were evaluated through a semi-structured questionnaire. ResultsMany children had excess weight (35.2%), abdominal adiposity (10.5%), and body fat (15.6%), as well as increased ApoB/ApoA1 ratio (14.7%), total cholesterol (51.8%), and triglycerides (19.8%). Children with excess weight and total and central fat had a higher prevalence of having a higher ApoB/ApoA1 ratio, as well as those with atherogenic lipid profile (increased LDL-c and triglycerides and low HDL-c). A direct association was found between the number of cardiovascular risk factors and the ApoB/ApoA1 ratio (p=0.001), regardless of age and income. ConclusionThe increased ApoB/ApoA1 ratio was associated with excess weight, body adiposity (total and central), and altered lipid profile in children. Children with a higher number of cardiovascular risk factors had higher ApoB/ApoA1 ratio, in both genders.

Association Between Carotid Intima Media Thickness, Age, and Cardiovascular Risk Factors in Children and Adolescents.

Measures of carotid intima media thickness (cIMT) in adults are correlated with adiposity and the metabolic syndrome (MetS) and predict cardiovascular (CV) events. Relations in children are not as well studied. Our objective was to determine the relations of cIMT with body mass index (BMI) and CV risk score in children. The study included 291 children (158 M/133 F) 6-18 years of age (140 aged 6-11/151 aged 12-18) with measurements of height, weight, waist circumference; fasting lipids, glucose, insulin, and cIMT. A CV risk cluster score was developed from sum of the z-scores of the five MetS components (waist circumference, blood pressure, serum triglycerides, high-density lipoprotein cholesterol, and insulin). Partial Pearson correlation coefficients were adjusted for age, sex, and race. There was no significant age difference in cIMT from 6 to 18 years of age. BMI and CV risk score were significantly correlated (P < 0.0001), and both were correlated with cIMT (r = 0.14, P = 0.02 and r = 0.16, P = 0.006, respectively). Slight age-related differences in associations of cIMT with CV risk score and BMI were explained by unusual values in a few children. These cross-sectional data in normal children show that cIMT was stable from childhood into adolescence. However, both BMI and CV risk score had small, but significant positive correlations with cIMT. Therefore, maintaining normal levels of adiposity and other risk variables may be useful in preventing early changes associated with preclinical atherosclerosis.

Effect of recombinant human growth hormone therapy on blood lipid and carotid intima-media thickness in children with growth hormone deficiency

BackgroundReports on the association between growth hormone deficiency (GHD) and cardiovascular risk factors in children are limited. We aim to investigate the effect of different doses of recombinant human growth hormone (rhGH) therapy on blood lipid and carotid intima-media thickness (cIMT) in Chinese GHD children.MethodsNinety children, including sixty isolated GHD children and thirty healthy children, were enrolled. GHD children were randomly divided into two groups (A and B) according to the rhGH dose given: group A received 0.23 mg/kg/week and group B received 0.35 mg/kg/week for 12 months. The TC, TG, LDL-C, HDL-C, and cIMT at baseline and after treatment were measured.ResultsThe height, weight, and height velocity improved significantly over 12 months of rhGH therapy in all GHD children. At baseline, GHD children in both the treatment groups showed significantly higher total cholesterol (TC), triglyceride (TG), low-density lipoprotein-cholesterol (LDL-C), cIMT, and lower high-density lipoprotein-cholesterol (HDL-C) than healthy children (all P≤0.033). After the 12-month rhGH therapy, a significant decrease in the TC, TG, LDL-C, and cIMT, as well as a significant increase in the HDL-C (P≤0.046), was observed in the GHD children, with change in the group B being even more marked.ConclusionsThe RhGH replacement therapy in GHD children can improve both the blood lipid profile and carotid intima-media thickness, with higher-dose rhGH therapy showing superior effects.

Thrombomodulin as a New Marker of Endothelial Dysfunction in Chronic Kidney Disease in Children.

Endothelial dysfunction (ED) and oxidative stress are potential new pathomechanisms of cardiovascular diseases in patients with chronic kidney disease (CKD). The aim of the study was to assess the association between endothelial dysfunction, oxidative stress biomarkers, and cardiovascular risk factors in children with CKD. Serum oxidized LDL (oxLDL), protein carbonyl group, urea, creatinine, cystatin C, thrombomodulin, asymmetric dimethylarginine (ADMA), von Willebrand factor, brain natriuretic peptide (BNP), lipids, high sensitivity C-reactive protein, intercellular adhesion molecule-1 levels, and albuminuria were measured. Anthropometric, ambulatory blood pressure (BP) measurements and echocardiography were performed. The studied group consisted of 59 patients aged 0.7–18.6 (mean 11.1) years with stages 1 to 5 CKD. Thrombomodulin strongly correlated with creatinine (R = 0.666; p < 0.001), cystatin C (R = 0.738; p < 0.001), BNP (R = 0.406; p = 0.001), ADMA (R = 0.353; p = 0.01), oxLDL (R = 0.340; p = 0.009), 24-hour systolic (R = 0.345; p = 0.011) and mean (R = 0.315; p < 0.05) BP values, and left ventricular mass index (LVMI, R = 0.293; p = 0.024) and negatively with estimated glomerular filtration rate (R = −0.716; p < 0.001). In children with CKD, TM strongly depended on kidney function parameters, oxLDL levels, and 24-hour systolic and mean BP values. Thrombomodulin seems to be a valuable marker of ED in CKD patients, correlating with CKD stage as well as oxidative stress, BP values, and LVMI.

Age- and gender-specific silent cardiovascular risk factors in children and adolescents: The PEP family heart study

Age- and gender-specific silent cardiovascular risk factors in children and adolescents: The PEP family heart study

The study of lipid profile and other cardiovascular risk factors in children born to parents having premature ischemic heart disease

The study of lipid profile and other cardiovascular risk factors in children born to parents having premature ischemic heart disease

Relationship of circulating spexin with markers of cardiovascular disease: a pilot study in adolescents with obesity.

Spexin, a novel peptide, has potential implications in obesity, satiety and energy homeostasis. The current study examined the relationship of spexin with various biomarkers of cardiovascular disease and endothelial function in adolescents with obesity. Nineteen adolescents with obesity (age, 15.8±1.7years) were studied. Spexin, leptin and various cardiovascular disease biomarkers were measured. Endothelial function was assessed by high-resolution Doppler ultrasonography of the right brachial artery. Spexin concentration (median [interquartile range] 0.38ng/mL [0.29-0.59ng/mL]) was inversely correlated (r=-0.50, P=0.03) with leptin. When participants were clustered into two groups ('high spexin and low leptin' vs. 'low spexin and high leptin'), the odds of having 'low spexin and high leptin' in participants with higher hs-CRP (≥ 3mg/L) were 12.25 times (95 per cent CI -1 to139, P=0.026) higher than those of participants with lower hs-CRP (<3mg/L). Spexin levels, however, were not associated with measures of endothelial function. The inverse association between spexin and leptin and the presence of higher concentrations of hs-CRP in adolescents with obesity in the setting of 'low spexin and high leptin' suggest a potential role for spexin in the regulation of satiety and certain cardiovascular risk factors in children with obesity.

Cardiovascular risk factors in children

IntroductionSystemic hypertension is one of the main risk factors for cardiovascular disease (CVD). Early diagnosis and treatment of hypertension in childhood can potentially have a significant impact on future adverse outcomes. ObjectiveTo investigate the relationship of diastolic (DBP) and systolic blood pressure (SBP) with anthropometric data and area of residence of children in municipalities of Rio Grande do Sul state, Brazil. MethodsThis is a cross-sectional study of 709 children between six and nine years of age. Blood pressure, weight, height and waist circumference (WC) were measured. Statistical tests had a maximum significance level of 5% (p≤0.05) and the software used was SPSS version 13.0. ResultsObesity was significantly associated with pre-hypertension, and stage 1 and 2 hypertension as assessed by DBP and SBP (≤0.05); high WC was significantly associated with a classification of pre-hypertension and stage 1 hypertension based on DBP and a classification of stage 1 and 2 hypertension based on SBP (≤0.01). ConclusionChildren living in urban areas had significantly higher mean SBP than those living in rural areas. Those with high WC presented higher SBP and DBP compared to children with normal WC. Obese children showed higher mean SBP and DBP compared to those who were overweight or normal weight and mean SBP and DBP also increased with older age and higher mean body mass index and WC.

Neck circumference and clustered cardiovascular risk factors in children and adolescents: cross-sectional study

ObjectiveEarly detection of cardiovascular disease (CVD) risk factors, such as obesity, is crucial to prevent adverse long-term effects on individuals’ health. Therefore, the aims were: (1) to explore the robustness...

Cardiovascular risk factors and mortality in children with chronic kidney disease.

Cardiovascular disease (CVD) begins early in children with chronic kidney disease (CKD), and its progression is determined by the presence of single or multiple cardiovascular risk factors (CVRFs). To determine the prevalence of CVRFs in children with CKD and their association with mortality in children on chronic dialysis. This comparative cross-sectional study recruited children aged 5 - 18 years with all stages of CKD. All patients had a short history taken along with a physical examination, and their blood samples were assessed for serum creatinine, urea, albumin, calcium, phosphorus, parathyroid hormone, alkaline phosphatase, total cholesterol (TC), haemoglobin and C-reactive protein. Urine samples were also assessed for proteinuria. One hundred and six children who met the study criteria were recruited, 34 with CKD I, 36 with CKD II - IV and 36 with CKD V (dialysis). The overall median age was 11 years (range 8 - 14), and the male/female ratio was 2.1:1. The most common CVRF was anaemia (39.6%). The rate of anaemia was higher in the dialysis group than in the CKD II - IV and CKD I groups (77.8%, 33.3% and 5.9%, respectively). Other CVRFs detected were hypertension, proteinuria, hypercholesterolaemia and dysregulated mineral bone metabolism. Seven deaths were recorded in the dialysis group during the study period. Severe hypertension and intracranial bleeding were the most common causes of death. Modifiable risk factors such as increased TC and decreased albumin levels were more common than other CVRFs in the dialysis patients who died. CVRFs may be present in early CKD, even before the decline in GFR. Routine screening for CVRFs, along with timely intervention, may prevent the progression of CVD and mortality later in life.

Does Potassium Deficiency Contribute to Hypertension in Children and Adolescents?

The increasing prevalence of cardiovascular risk factors in children and adolescents has been largely, but not entirely, related to the childhood obesity epidemic. Among the noted risk factors detectable in children is elevated blood pressure. Emerging findings indicate that in addition to overweight and obesity, sodium intake is associated with elevated blood pressure in youth. Moreover, dietary sodium intake is quite high and well above recommended levels throughout childhood. In adults, the relationship of sodium consumption with hypertension is well established, and there is evidence from both population and clinical studies that potassium intake is also associated with blood pressure. Higher potassium intake is associated with lower blood pressure; and potassium deficit leads to an increase in blood pressure. Findings on relationships of potassium intake with blood pressure in childhood are sparse. There are some reports that provide evidence that a dietary pattern that includes potassium-rich foods is associated with lower blood pressure and may also lower blood pressure in adolescents with elevated blood pressure. Considering the secular changes in dietary patterns throughout childhood, it is prudent to encourage a diet for children that is high in potassium-rich foods.

Positive Psychosocial Factors in Childhood Predicting Lower Risk for Adult Type 2 Diabetes: The Cardiovascular Risk in Young Finns Study, 1980–2012

Type 2 diabetes is a public health concern, but psychosocial factors that may protect against the disease are unknown. This study examines whether a positive psychosocial environment in childhood is associated with lower risk for Type 2 diabetes in adulthood or healthier glucose trajectories over the life course, and whether BMI mediates the associations. A cohort of 3,596 Finnish children was followed into adulthood over 32 years. An overall positive psychosocial score, consisting of six subdomains, was measured at study baseline (1980). Relative risk ratios and multilevel growth curve modeling were used to examine associations of the psychosocial score with Type 2 diabetes (2012) and glucose trajectories (1986-2012). The mediating effect by BMI was examined using mediation analysis. The analyses were conducted between June 2015 and January 2016. There was a 21% decrease in the rate of Type 2 diabetes (relative risk ratio, 0.79; 95% CI=0.66, 0.94) for each 1-SD increase in the positive psychosocial score after adjustment for childhood cardiovascular risk factors and dietary behaviors. Adult BMI mediated 52% and weight gain mediated 25% of the association. The growth curve model showed healthier glucose trajectories (age X psychosocial score interaction, b= -0.01; p=0.010) for participants with higher versus lower positive psychosocial score in childhood. Positive psychosocial environment in childhood seems to have beneficial influences on the risk for Type 2 diabetes over the life span. RCTs will be required to see if interventions directed at early-life circumstances are warranted.