Clustered Cardiometabolic Risk Research Articles

Associations of 24 h time-use compositions of sitting, standing, physical activity and sleeping with optimal cardiometabolic risk and glycaemic control: The Maastricht Study.

The associations of sitting, standing, physical activity and sleep with cardiometabolic health and glycaemic control markers are interrelated. We aimed to identify 24 h time-use compositions associated with optimal metabolic and glycaemic control and determine whether these varied by diabetes status. Thigh-worn activPAL data from 2388 participants aged 40-75 years (48.7% female; mean age 60.1 [SD = 8.1] years; n=684 with type 2 diabetes) in The Maastricht Study were examined. Compositional isometric log ratios were generated from mean 24 h time use (sitting, standing, light-intensity physical activity [LPA], moderate-to-vigorous physical activity [MVPA] and sleeping) and regressed with outcomes of waist circumference, fasting plasma glucose (FPG), 2 h plasma glucose, HbA1c, the Matsuda index expressed as z scores, and with a clustered cardiometabolic risk score. Overall analyses were adjusted for demographics, smoking, dietary intake and diabetes status, and interaction by diabetes status was examined separately. The estimated difference when substituting 30 min of one behaviour with another was determined with isotemporal substitution. To identify optimal time use, all combinations of 24 h compositions possible within the study footprint (1st-99th percentile of each behaviour) were investigated to determine those cross-sectionally associated with the most-optimal outcome (top 5%) for each outcome measure. Compositions lower in sitting time and with greater standing time, physical activity and sleeping had the most beneficial associations with outcomes. Associations were stronger in participants with type 2 diabetes (p<0.05 for interactions), with larger estimated benefits for waist circumference, FPG and HbA1c when sitting was replaced by LPA or MVPA in those with type 2 diabetes vs the overall sample. The mean (range) optimal compositions of 24 h time use, considering all outcomes, were 6 h (range 5 h 40 min-7 h 10 min) for sitting, 5 h 10 min (4 h 10 min-6 h 10 min) for standing, 2 h 10 min (2 h-2 h 20 min) for LPA, 2 h 10 min (1 h 40 min-2 h 20 min) for MVPA and 8 h 20 min (7 h 30 min-9 h) for sleeping. Shorter sitting time and more time spent standing, undergoing physical activity and sleeping are associated with preferable cardiometabolic health. The substitutions of behavioural time use were significantly stronger in their associations with glycaemic control in those with type 2 diabetes compared with those with normoglycaemic metabolism, especially when sitting time was balanced with greater physical activity.

Clustered Cardiometabolic Risk and the "Fat but Fit Paradox" in Adolescents: Cross-Sectional Study.

The "fat but fit paradox" states that people who are fit have a lower cluster cardiometabolic risk (CCMR), even if they are overweight or obese. Therefore, the objective was to investigate the CCMR between four categories based on the "fat but fit paradox" variable, in different fitness categories-cardiorespiratory fitness, muscular fitness, and physical fitness-in adolescents. Body composition, cardiorespiratory fitness, muscle fitness, blood samples, and blood pressure were assessed in 230 adolescents, and cardiometabolic risk and three different "fat but fit paradox" variables were calculated. Participants with a higher CRF exhibited a lower CCMR within their body mass index (BMI) category (p < 0.05). Participants with a high BMI and high muscular fitness showed a lower CCMR than participants with a low muscular fitness and a similar BMI, or low BMI and low muscular fitness (p < 0.05). When both variables, CRF and muscular fitness, were combined, their effectabove CCMR increased (p < 0.05). Across all fitness categories, the fat and unfit group, whether considered individually or combined, exhibited the highest risk of CCMR (p < 0.05). This study confirms the "fat but fit paradox" in different physical fitness categories, showing the importance of both CRF and muscular fitness as predictors of CCMR, with the combination of both variables showing a greater agreement.

Associations of overweight and obesity with cardiometabolic risk factor clusters among Korean adolescents

This study investigated the association between overweight, obesity, and cardiometabolic risk factor clusters in Korean adolescents. We included 2182 participants (1161 boys and 1021 girls) aged 12–18 years from the Korea National Health and Nutrition Examination Survey (2016–2021). Cardiometabolic risk factors include hypertension, high low-density lipoprotein cholesterol (LDL-C) level, low high-density lipoprotein cholesterol (HDL-C) level, hypertriglyceridemia, high fasting plasma glucose level, elevated alanine aminotransferase level, and hyperuricemia. The average age was 15.1 ± 0.1 years in both boys and girls. The proportion of subjects with ≥ 1, ≥ 2, and ≥ 3 cardiometabolic risk factors was 76.5%, 49.8%, and 22.7% in obese adolescents, and 60.5%, 24.0%, and 9.1%, in overweight adolescents, respectively. Compared to adolescents with underweight/normal weight, the odds ratios (ORs) and 95% confidence intervals for the clustering of cardiometabolic risk factors were at 2.76 (1.74–4.38) for ≥ 1; 3.75 (2.11–6.66) for ≥ 2; and 4.75 (1.70–13.25) for ≥ 3 factors in obese adolescents and 1.88 (1.26–2.81) for ≥ 1 factor in overweight adolescents. Overweight and obese adolescents exhibited high cardiometabolic risk clustering. Prevention and management of overweight/obesity in Korean adolescents are emerging to mitigate health risk associated with this condition.

Fitness and fatness in children and adolescents: investigating their role in the association between physical activity and cardiometabolic health.

To verify the role of the combination of fitness and fatness in the relationship between physical activity (PA) and cardiometabolic risk in children and adolescents. This is a cross-sectional study performed with 2786 children and adolescents (6 to 17 years). Fitness was determined by the cardiorespiratory fitness (CRF) six-minute walking and running test. Waist circumference (WC) was considered a fatness indicator. A selfreported questionnaire was used to determine PA practice, whereas the clustered cardiometabolic risk score (cMetS) was calculated by summing z-scores of triglycerides, total cholesterol/HDL-C ratio, systolic blood pressure, glucose, and WC. Considering the combination of CRF (fitness) and WC (fatness), the following phenotypes were created: Fit/Unfat, Fit/Fat, Unfit/Unfat and Unfit/Fat. Moderation analyses were tested using linear regression models. Significant interactions were found between PA and Unfit/Fat category (β = -0.001; p = 0.001) only for adolescents. The interaction observed in the Unfit/Fat phenotype indicated that adolescents who practise PA for 330 minutes per week presented lower cMetS compared to those who do not practise or practise for 60 minutes respectively. The combination of fitness and fatness moderates the relationship between PA and cardiometabolic risk, suggesting that adolescents, particularly those who are less fit and present high adiposity, should be encouraged to engage in regular PA to improve their metabolic health.

Physical Activity Assessed by Wrist and Thigh Worn Accelerometry and Associations with Cardiometabolic Health.

Physical activity is increasingly being captured by accelerometers worn on different body locations. The aim of this study was to examine the associations between physical activity volume (average acceleration), intensity (intensity gradient) and cardiometabolic health when assessed by a thigh-worn and wrist-worn accelerometer. A sample of 659 office workers wore an Axivity AX3 on the non-dominant wrist and an activPAL3 micro on the right thigh concurrently for 24 h a day for 8 days. An average acceleration (proxy for physical activity volume) and intensity gradient (intensity distribution) were calculated from both devices using the open-source raw accelerometer processing software GGIR. Clustered cardiometabolic risk (CMR) was calculated using markers of cardiometabolic health, including waist circumference, triglycerides, HDL-cholesterol, mean arterial pressure and fasting glucose. Linear regression analysis assessed the associations between physical activity volume and intensity gradient with cardiometabolic health. Physical activity volume derived from the thigh-worn activPAL and the wrist-worn Axivity were beneficially associated with CMR and the majority of individual health markers, but associations only remained significant after adjusting for physical activity intensity in the thigh-worn activPAL. Physical activity intensity was associated with CMR score and individual health markers when derived from the wrist-worn Axivity, and these associations were independent of volume. Associations between cardiometabolic health and physical activity volume were similarly captured by the thigh-worn activPAL and the wrist-worn Axivity. However, only the wrist-worn Axivity captured aspects of the intensity distribution associated with cardiometabolic health. This may relate to the reduced range of accelerations detected by the thigh-worn activPAL.

Neighborhood socioeconomic status and cardiometabolic risk: mediating roles of domain-specific physical activities and sedentary behaviors

PurposeWe examined the potential mediating roles of domain-specific physical activities and sedentary behaviors in the relationship between area-level socioeconomic status (SES) and cardiometabolic risk. MethodsData were from the 2011/2012 Australian Diabetes, Obesity and Lifestyle study (n = 3431). The outcome was a clustered cardiometabolic risk (CCR) score, and the exposure was suburb-level SES. Potential mediators were domain-specific physical activities and sedentary behaviors. Multilevel linear regression models examined associations between SES and potential mediators (α) and between mediators and CCR (β). Mediation was assessed using the joint-significance test. ResultsHigher SES was associated with a lower CCR score. Lower SES was associated with less frequent walking for transport, lower vigorous-intensity recreational physical activity, and higher TV time, which were associated with higher CCR scores. However, higher SES was associated with longer transport-related sitting time (all modes and in cars), which were associated with higher CCR scores. ConclusionsThe SES-cardiometabolic risk relationship may be partially explained by walking for transport, vigorous-intensity recreational physical activity, and TV viewing. These findings, which require corroboration from prospective evidence and clarification of the roles of transport-related sitting and occupational physical activity, can inform initiatives addressing socioeconomic inequalities in cardiometabolic health.

Higher vegetable consumption is related to a lower risk of cardiometabolic risk cluster among children and adolescents: A national cross-sectional study in China

Background and aimsEvidence about the association between vegetable consumption and cardiometabolic risk factors (CMRFs) cluster among children and adolescents was inconsistent. We aimed to investigate the prevalence of CMRFs and CMRFs cluster, and to evaluate their associations with vegetable consumption. Methods and resultsA total of 14,061 participants aged 6–19 years were recruited from 7 provinces of China. A standard physical examination, including height, weight and blood pressure, was conducted. Information regarding CMRFs was obtained through anthropometric measurements and blood sample testing, while weekly frequency and daily servings of vegetable consumption data collected by questionnaires. Logistic regression models were used to analyze the odds ratios (OR) for associations between CMRFs, CMRFs cluster and vegetable consumption. The prevalence of no CMRFs cluster among children and adolescents was 26.4%. Participants whose daily vegetable consumption was 0.75–1.5 and ≥1.5 servings showed a lower risk of high blood pressure (HBP), high total cholesterol (TC), high triglyceride (TG), and high low-density lipoprotein cholesterol (LDL-C) compared to those with daily vegetable consumption of <0.75 servings. Besides, higher average daily vegetable consumption was strongly associated with lower risks of CMRFs cluster. Stratified analyses showed that the protective effects of more vegetable intake on CMRFs cluster were profounder in boys and young adolescents. ConclusionMore vegetable intake was associated with lower risks of CMRFs cluster in Chinese children and adolescents aged 6–19 years, which further highlighted the significance of vegetable consumption to improve the cardiometabolic risk status.

Moderate-to-vigorous physical activity, but not sedentary time, predicts changes in cardiometabolic risk factors in 10-y-old children: the Active Smarter Kids Study

Background: Cross-sectional data have suggested an inverse relation between physical activity and cardiometabolic risk factors that is independent of sedentary time. However, little is known about which subcomponent of physical activity may predict cardiometabolic risk factors in youths. Objective: We examined the independent prospective associations between objectively measured sedentary time and subcomponents of physical activity with individual and clustered cardiometabolic risk factors in healthy children aged 10 y. Design: We included 700 children (49.1% males; 50.9% females) in which sedentary time and physical activity were measured with the use of accelerometry. Systolic blood pressure, waist circumference (WC), and fasting blood sample (total cholesterol, high-density lipoprotein cholesterol, triglycerides, glucose, fasting insulin) were measured with the use of standard clinical methods and analyzed individually and as a clustered cardiometabolic risk score standardized by age and sex (z score). Exposure and outcome variables were measured at baseline and at follow-up 7 mo later. Results: Sedentary time was not associated with any of the individual cardiometabolic risk factors or clustered cardiometabolic risk in prospective analyses. Moderate physical activity at baseline predicted lower concentrations of triglycerides (P = 0.021) and homeostatic model assessment for insulin resistance (P = 0.027) at follow-up independent of sex, socioeconomic status, Tanner stage, monitor wear time, or WC. Moderate-to-vigorous physical activity (P = 0.043) and vigorous physical activity (P = 0.028) predicted clustered cardiometabolic risk at follow-up, but these associations were attenuated after adjusting for WC. Conclusions: Physical activity, but not sedentary time, is prospectively associated with cardiometabolic risk in healthy children. Public health strategies aimed at improving children’s cardiometabolic profile should strive for increasing physical activity of at least moderate intensity rather than reducing sedentary time. This trial was registered at clinicaltrials.gov as NCT02132494.

The Longitudinal Association of Cardiorespiratory Fitness and Adiposity With Clustered Cardiometabolic Risk: A Mediation Analysis.

Previous literature has demonstrated the mediating role of adiposity in the association between cardiorespiratory fitness (CRF) and cardiometabolic risk as well as the potential role of CRF in attenuating the adverse consequences associated with excess weight. This study aimed to evaluate the mediating role of CRF and adiposity in the possible association with cardiometabolic risk. Observational 3-year longitudinal study that included 420 children and adolescents (10.50 [2.05]y of age at baseline; 56.2% girls). Body mass index (BMI) was calculated, and CRF was evaluated using field assessments. A clustered cardiometabolic risk score (cMetS) was calculated from glucose, systolic blood pressure, total cholesterol/high-density lipoprotein cholesterol ratio, and triglycerides z scores. Analyses evaluated the mediating role of BMI in the association between CRF and cMetS as well as whether CRF mediated the association between BMI and cMetS. BMI at baseline was directly associated with the cMetS at follow-up (0.102; 95% confidence interval, 0.020 to 0.181), independently of CRF, whereas CRF was only indirectly associated with cMetS at follow-up through BMI (-0.036; 95% confidence interval, -0.070 to -0.009), meaning that the association between CRF and cMetS was explained via the mediation role of BMI. BMI presented direct association with cMetS, whereas CRF exhibited indirect association with cMetS mediated via BMI.

Obesogenic environment around schools is associated with atherogenic risk in Brazilian children.

Cardiometabolic risk factors often emerge in childhood, increasing the risk of cardiovascular diseases in adulthood. The school environments represent an important active space in a child's routine and may influence their health status. In this cross-sectional study, we aimed to evaluate the clustering of cardiometabolic risk factors and its association with the obesogenic and leptogenic environment around schools. A total of 378 children (181 boys; 197 girls) aged 8 and 9 years, enrolled in all urban schools of Viçosa, Minas Gerais, Brazil, were evaluated. Concentrations of high-density lipoprotein-cholesterol (HDL-c) and triglycerides (TG), and the insulin resistance (HOMA-IR), waist circumference (WC), and mean arterial pressure (MAP) were measured. The neighborhood income, walkability index, predominantly ultra-processed food stores, public spaces for leisure and/or physical activities, traffic accidents, crime and green spaces densities were assessed in 400 road network buffers around schools. To test association of the obesogenic and leptogenic environment around schools with cardiometabolic risk clustering, binary logistic regression models were performed with generalized estimating equations. "Obesogenic school environments" had greater densities of ultra-processed food stores, crime and traffic accidents, and higher walkability. The "↓ Atherogenic risk" cluster consisted of higher HDL-c values. There was an inverse association between the obesogenic environment around schools and a child's "↓ atherogenic risk" clustering (OR=0.63; p < 0.001). We concluded that public policies aimed at modifying the environment around schools, by providing healthier food options and safe conditions for active mobility, are essential to prevent child's atherogenic risk.

Neighborhood obesogenic environment and cardiometabolic risk in Brazilian children: The mediation role of the mother's body mass index.

We aimed to evaluate the association of neighborhood obesogenic and leptogenic environments with cardiometabolic risk clustering among Brazilian schoolchildren, mediated by child's ultra-processed food consumption and the mother's body mass index (BMI). A total of 367 children aged 8-9 years, enrolled in urban schools of Viçosa, Minas Gerais, Brazil, were evaluated. Waist circumference, insulin resistance, blood pressure, high-density lipoprotein-cholesterol, and triglycerides concentrations were measured. The child's ultra-processed food consumption assessment was performed by applying three 24-hour dietary recall. The mother's weight and height values were used to calculate the BMI. The neighborhood income, walkability index, predominantly ultra-processed food stores, public spaces for leisure, and/or physical activities, traffic accidents, crime, and green spaces densities were assessed in four hundred road network buffers around households. From neighborhood and cardiometabolic risk variables, four latent variables were obtained from confirmatory factor analysis: neighborhood "obesogenic", and "leptogenic" environments; "high cardiometabolic risk," and "low atherogenic risk". A structural equation model was used to test the direct and indirect associations between neighborhood environment and cardiometabolic risk clusters. The neighborhood obesogenic environment had a significant total association (Standardized Coefficient=0.172, p= .011) and was indirectly associated with the child's "high cardiometabolic risk" cluster, mediated by the mother's body mass index (Standardized Coefficient=0.066, p= .049). Our results reinforce the role of the urban environment on maternal obesity and child's cardiometabolic risk and provide evidence for public health policies aimed to prevent such conditions.

IS THE AMOUNT OF WEIGHT LOSS AFTER BARIATRIC SURGERY A FACTOR DETERMINING CARDIOMETABOLIC RISK REDUCTION?

Objective: This study aimed to investigate whether differential weight loss amount appropriately reflects improvements in cardiometabolic health in patients undergoing bariatric surgery. Materials and Methods: Patients who underwent bariatric surgery (BS) and were followed up for six months were divided into three groups according to their weight loss (Group-1: Low weight loss; Group-2: Moderate weight loss; Group-3: High weight loss). Before and after surgery, patients were evaluated for metabolic syndrome (MetS) using waist circumference, blood pressure, glucose, HDL-C, and triglyceride data, and a clustered cardiometabolic risk (CMR) score was obtained for each patient using a calculator available in the literature online. Changes in each MetS criterion and CMR score in the groups before and after the operation, and their relations with each other were compared. Results: Sixty-six patients were included in the study. It was observed that the prevalence of MetS, which was 74.2% before the operation, decreased to 25.8%. A significant difference was observed between the groups in the decrease in weight, waist circumference, fat mass, fasting blood sugar, and HOMA-IR values. However, no significant difference was found between the groups in the change in MetS parameters and CMR scores. While a significant negative correlation was found between the amount of weight loss and the difference in the CMR score, no relation was observed between each MetS parameter and the amount of weight loss. It was also found that each 1% increase in weight loss was associated with a 57% decrease in the CMR score. Conclusion: Although there is a significant decrease in cardiometabolic risk parameters after bariatric surgery, the amount of weight loss of the patients does not affect the individual parameters. However, using a scoring system to evaluate and monitor patients’ cardiometabolic cluster risks will make it possible to follow the gradual changes in patients after surgery, making interventions by physicians and nutritionists more targeted and efficient.

The independent and combined effects of single-child status and ideal lifestyle on clustered cardio-metabolic risk factors among Chinese children and adolescents.

BackgroundCardio-metabolic risk factors (CMRFs) represent the accumulation of metabolic abnormalities, significantly increasing the likelihood of cardiovascular diseases. Although studies assessed the independent association of single-child status and lifestyle risk factors with components of CMRFs or clustered CMRFs, little has been known about the combined effect of single-child status and lifestyles on clustered CMRFs as well as sex differences.Materials and methodsData was collected from a cross-sectional survey conducted in September 2013 in China. A total of 13,859 children and adolescents aged 7–18 years with blood samples were included. Anthropometric measurements and serum biochemical indexes were collected to assess clustered CMRFs, while questionnaires were used to obtain single-child status, lifestyle information, and characteristics of children and their parents. Mixed effect logistic regression was applied to analyze the independent and the combined effects of single-child status and ideal lifestyle category on clustered CMRFs.ResultsThe prevalence of clustered CMRFs was 3.4%, with a higher prevalence in boys (4.0%) than girls (2.7%). Children and adolescents with clustered CMRFs had a higher proportion of single children (76.6 vs. 69.7%) and unfavorable lifestyles (62.1 vs. 29.2%) compared with their peers with non-clustered CMRFs. Both single children (OR = 1.67, 95% CI: 1.32–2.11) and unfavorable lifestyles (OR = 9.03, 95% CI: 6.26–13.02) were associated with an increased risk of clustered CMRFs. The risk of clustered CMRFs increased significantly (OR = 12.79, 95% CI: 6.67–24.52) when single children and an unfavorable lifestyle were combined, which was almost neutralized (OR = 1.33, 95% CI: 0.63–2.82) when single children adhered to a favorable lifestyle. However, no sex differences were observed in this study.ConclusionSingle children with unfavorable lifestyles were associated with an obvious risk of clustered CMRFs, which might be partially offset by expanding family size (the number of siblings) or establishing a favorable lifestyle. A birth-friendly social environment as well as a family environment with a favorable lifestyle are encouraged in China.

Cardiometabolic factors explaining the association between physical activity and quality of life: U.S. National Health and Nutrition Examination Survey

Background/ObjectiveTo test the Clustered Cardiometabolic Risk (CCMR) factor explaining the relationship between physical activity and physical quality of life (QOL). MethodsUsing the U.S. National Health and Nutrition Examination Survey 2003–2006, 2,445 adults completed the CDC Healthy Days Questionnaire for measuring QOL, wore the accelerometer for assessing physical activity pattern (PAP), and completed triglyceride, glucose, serum insulin, waist circumference, blood pressure, and HDL-cholesterol tests from which the CCMR factor was created. Physical QOL was classified as poor (≥14 days with poor physical health within past 30 days) vs. good (<14 days). We classified PAP by moderate-to-vigorous physical activity (MVPA), light-intensity physical activity (LIPA), and sedentary behavior (SB). We defined MVPA, LIPA, and SB as ≥2020 counts/minute, 100–2019 counts/minute, and ≤99 counts/minute, respectively. We further classified PAP status as unhealthy (MVPA <150 min/week & SB>LIPA) or healthy (MVPA <150 min/week & SB<LIPA, or MVPA ≥150 min/week regardless of SB>LIPA or SB<LIPA). Logistic regressions analyzed the association between unhealthy PAP and poor physical QOL, adjusting for the CCMR factor, age, sex, education, and smoking behavior. ResultsCompared with having healthy PAP, individuals having unhealthy PAP had an elevated risk of poor physical QOL (OR = 1.96; 95% CI = 1.42–2.72). However, this association was explained by higher levels of the CCMR factor (OR = 1.46; 95% CI = 1.07–1.99) through poorer serum insulin (OR = 1.35; 95% CI = 1.04–1.75) and waist circumference (OR = 1.23; 95% CI = 1.02–1.50). ConclusionThe CCMR factor (typically insulin and waist circumference) explained the association between unhealthy physical activity and poor physical QOL.

Associations of Vigorous Gardening With Cardiometabolic Risk Markers for Middle-Aged and Older Adults.

This study investigates the associations of vigorous-intensity gardening time with cardiometabolic health risk markers. This cross-sectional study (AusDiab) analyzed 2011-2012 data of 3,664 adults (55% women, mean [range], age = 59.3 [34-94] years) in Australia. Multiple linear regression models examined associations of time spent participating in vigorous gardening (0, <150min/week, ≥150min/week) with a clustered cardiometabolic risk (CMR) score and its components, for the whole sample and stratified by age and gender. Of participants, 61% did no vigorous gardening, 23% reported <150min/week, and 16% reported ≥150min/week. In the whole sample, spending ≥150min/week in vigorous gardening was associated with lower CMR (lower CMR score, waist circumference, diastolic blood pressure, and triglycerides) compared with no vigorous gardening. Stratified analyses suggested that these associations were almost exclusively observed for older adults and women. These findings suggest the public health potential of vigorous-intensity gardening in reducing CMR.

Cardiometabolic risk, biomarkers of low-grade subclinical inflammation and flavonoid intake: A cross-sectional study in Argentina

BackgroundFlavonoids, the most abundant polyphenols present in the diet, may help to reduce the risk of cardiometabolic disease. Hence, the aim of this study was to know the potential associations between flavonoid source food intake, markers of low-grade inflammation and cardiometabolic risk status. Methods194 adult subjects attending at the Cardiology Division, Hospital Nacional de Clínicas, Córdoba, Argentina participated in the study. A validated food-frequency questionnaire was applied to establish the flavonoid source food intake. Clinical-pathological and anthropometric variables [height, weight, and waist circumference, and serum concentrations of high-sensitive C-reactive protein (hs-CRP) and cytokines (INF-γ, TNFα, IL-6, IL-8, IL-10, IL-18, IL-23) were measured. A cardiometabolic risk clustering score was constructed and correlation’s coefficients and multiple linear regression models were used to assess the relation between flavonoid source foods consumption of and markers of low-grade inflammation. Results40.4% of the subjects were obese and 60.3% showed a very high risk of developing cardiovascular diseases according to the WC classification. 43.3% had a high risk of cardiometabolic dysregulation and the hs-CRP levels indicated a high risk of developing cardiovascular disease in the future both in men and women. The predominant intake of flavonoids was from source food of flavanones, flavones and flavonols. Negative associations between isoflavone source food intake and TNFα, IL-6 and IL-8 concentrations (P ≤ 0.05) were observed. ConclusionsThe results of the present study provide evidence of the inverse association between isoflavone source foods intake and inflammation. Further studies are needed to confirm retrieved association.

The Protective Role of Physical Fitness on Cardiometabolic Risk During Pregnancy: The GESTAtion and FITness Project.

Physical fitness (PF) is a cornerstone of metabolic health. However, its role in maternal-fetal metabolism during pregnancy is poorly understood. The present work investigates: (i)the association of PF with maternal and fetal cardiometabolic markers, and with clustered cardiometabolic risk during pregnancy, and (ii)whether being fit counteracts cardiometabolic abnormalities associated with overweight/obesity. Several PF components (flexibility, lower and upper body strength, and cardiorespiratory fitness [CRF]) were objectively assessed in 151 pregnant women at gestational weeks 16 and 33, and an overall PF cluster score calculated. At the same times, maternal glycemic and lipid markers, cortisol, and C-reactive protein were assessed with standard biochemical methods, along with blood pressure and a proxy for insulin resistance, and a cardiometabolic risk cluster score determined. These analytes were also measured in maternal and umbilical cord arterial and venous blood collected at delivery. PF was found to be associated with several maternal and a small number of fetal cardiometabolic markers (p < .05). Lower and upper body muscle strength, CRF, overall PF (week 16), and CRF changes (weeks 16-33) were inversely associated with clustered cardiometabolic risk (p < .05). Normal weight fit women had lower values for insulin level, insulin resistance, triglycerides, low-density lipoprotein cholesterol, C-reactive protein, and diastolic blood pressure than did overweight/obese unfit women at week 16 (p < .05). In conclusion, greater PF, especially muscle strength and CRF in early-middle pregnancy, appears to be associated with a better metabolic phenotype, and may protect against maternal cardiometabolic risk. "Keep yourself fit and normal weight before and during early pregnancy" should be a key public health message.

Health at Every Size®-Based Interventions May Improve Cardiometabolic Risk and Quality of Life Even in the Absence of Weight Loss: An Ancillary, Exploratory Analysis of the Health and Wellness in Obesity Study.

We examined whether weight loss following HAES®-based interventions associates with changes in cardiometabolic risk factors and quality of life of women with obesity. This was an exploratory, ancillary analysis of a 7-month, mixed-method, randomized controlled trial. Fifty-five women (age: 33.0 ± 7.2; BMI: 30–39.9 kg/m2) were included in this study. Body weight, cardiovascular risk factors, clustered cardiometabolic risk, and quality of life were assessed before (Pre) and after HAES®-based interventions (Post). Delta scores (Post-Pre) were calculated for each outcome and used in linear regression models. After adjusting by potential confounders, weight loss was associated with improvements in waist circumference (β = 0.83, p <0.001), fasting glycemia (β = 0.45, p = 0.036), total cholesterol (β = 1.48, p = 0.024), LDL (β = 1.33, p = 0.012), clustered cardiometabolic risk (β = 0.18, p = 0.006), and quality of life (β = −1.05, p = 0.007). All participants but one who reduced body weight (n = 11) improved clustered cardiometabolic risk and quality of life. Of relevance, 34% and 73% of the participants who maintained or gained weight improved clustered cardiometabolic risk and quality of life, respectively, although the magnitude of improvements was lower than that among those who lose weight. Improvements in cardiovascular risk factors and quality of life following HAES®-based interventions associated with weight loss as expected. However, most of the participants who maintained or even gained weight experienced benefits to some extent. This suggests that weight-neutral, lifestyle-modification interventions may improve wellness and health-related outcomes, even in the absence of weight loss.

Low performance-related physical fitness levels are associated with clustered cardiometabolic risk score in schoolchildren: a cross-sectional study

PurposeThe study aim was to verify if there were associations between performance-related physical fitness levels and the clustered cardiometabolic risk score among children and adolescents.MethodsThe cross-sectional study involved 1200 (655 females) children and adolescents aged 7–17 years. Performancerelated physical fitness levels (upper limb strength [ULS], lower limb strength [LLS], agility, speed, and cardiorespiratory fitness [CRF]) were evaluated and categorized as healthy or unhealthy levels. Waist circumference, systolic blood pressure, glucose, and blood lipoprotein (triglycerides, total cholesterol, and high-density lipoprotein cholesterol) were measured. The clustered cardiometabolic risk score constituted the sum of internationally-derived standardized values (z-scores) for each risk factor divided by 5. Associations between performance-related physical fitness levels and the clustered cardiometabolic risk score were determined with linear regression models.ResultsParticipants with healthy ULS levels exhibited a less favourable clustered cardiometabolic risk score, whereas healthy levels of LLS, agility (only in girls), and CRF (only in boys) were related with a more favourable clustered cardiometabolic risk score. ULS (β: –0.091 [95% CI: –0.120; –0.062]), LLS (β: –0.272 [95% CI: –0.368; –0.177]), and CRF (β: –0.218 [95% CI: –0.324; –0.112]) were inversely associated with the clustered cardiometabolic risk score, while agility (β: 0.112 [95% CI: 0.082; 0.142]) and speed (β: 0.079 [95% CI: 0.039; 0.119]) demonstrated a positive association with the clustered cardiometabolic risk score.ConclusionsOur results emphasize the importance of following moderate-to-vigorous physical activity guidelines to better develop physical fitness levels for the maintenance of cardiometabolic health during childhood and adolescence.

Biological and socioeconomic factors as moderator in relationship between leisure-time physical activity and cardiometabolic risk in adolescents from southern Brazil

BackgroundGiven the important repercussions that sociodemographic factors can have on physical activity, especially in the field of leisure, and cardiometabolic risk, it seems relevant to analyze the implications of these variables on the relationship between physical activity in leisure time (LTPA) and cardiometabolic risk. In this sense, the present study aims to verify the moderating role of biologic and socioeconomic factors in the relationship between LTPA and cardiometabolic risk in adolescents in southern Brazil.MethodsCross-sectional study that included 1596 adolescents selected at random (58.2% girls), aged between 10 and 17 years. LTPA, biological and socioeconomic factors were assessed using a self-reported questionnaire and the cardiometabolic risk score (total cholesterol/HDL-c ratio, triglycerides, fasting glucose, systolic blood pressure, and waist circumference, considering the participant’s age and sex) was included as an outcome. Associations and moderations were tested by multiple linear regression models.ResultsIt was observed a positive interaction of LTPA and sex (p = 0.048) and LTPA and school system (p = 0.037), and negative interaction of LTPA and skin color (p = 0.040), indicating that these factors were moderators in the relationship between LTPA and clustered cardiometabolic risk score (cMetS) in adolescents. A reduction in cardiometabolic risk was observed according to the increase in weekly minutes of LTPA among boys, non-white adolescents, and students from municipal schools.ConclusionsThe association between LTPA and cardiometabolic risk was moderated by sex, skin color, and school system in adolescents from southern Brazil.