Higher Risk Of Chronic Disease Research Articles

Physical Activity Intervention Adaptation: Recommendations from Rural American Indian Older Adults.

Preventive interventions are critical to improving health equity among American Indian (AI) populations, yet interventions that promote physical activity (PA) among AI populations are scarce. This research addresses the research-to-practice gap by informing the adaption and implementation process of evidence-based interventions (EBIs) among rural AI older adults. We used a community-based approach and an Indigenous-focused adaptation theoretical framework. Qualitative, semi-structured interviews elicited detailed information on preferences for PA intervention among rural AI older adults. We applied a collaborative directed content analysis strategy, and established trustworthiness and relevance using an inter-rater reliability process and member checking. We conducted 21 interviews, all participants identified as AI, the mean age was 66years (SD = 7.6), and 57% were female. Themes characterized contextual and cultural intervention considerations for adapting and implementing evidence-based PA interventions in rural AI older adults. Key findings included an emphasis on social and community interaction, strategies for targeted engagement, preference for group format, pairing PA sessions with shared meals, and inclusiveness in the PA intervention across ability levels and age groups. This study identified opportunities for adaptation of PA-focused EBIs among rural AI older adults. Findings can be applied to support the adaptation and implementation of effective and relevant PA-focused preventive interventions among this population which is at high risk for chronic disease and health disparities.

Comparison of Grip Strength, Gait Speed, and Quality of Life Among Obese, Overweight, and Nonobese Older Adults

Introduction: Obesity is related to a high risk of chronic diseases and increased rate of morbidity. This study was performed to compare grip strength, gait speed, and quality of life among obese, overweight, and nonobese older adult women. Methods: The study population consisted of 62 older adult women older than 65 years. The subjects were classified according to body mass index (BMI) as obese (BMI ≥25 kg/m2; n = 25), overweight (BMI 23-24.9 kg/m2; n = 13), or nonobese (BMI 18.5-22.9 kg/m2; n = 24). Grip strength and gait speed were measured, and quality of life was determined according to the 36-Item Short Form Health Survey (SF-36) questionnaire. One-way analysis of variance with Bonferroni's post hoc analysis was used to analyze the differences in grip strength, gait speed, and SF-36 score among the 3 groups. Results: There were significant differences in grip strength (F = 8.053, P = .001) and gait speed (F = 4.850, P = .011), but not in the physical (F = 2.194, P = .121) and mental (F = 1.247, P = .295) composite of the SF-36, among the 3 groups. The obese group showed significantly lower grip strength and slow gait speed compared with the overweight and nonobese groups. Conclusions: Obesity in older women has a negative impact on grip strength and gait speed. Grip strength and gait speed reflect health status in older adults, and the findings presented here suggest that grip strength and gait speed should be considered for obesity management in older women.

DNA Methylation Modulates Aging Process in Adipocytes.

Aging has been recognized to be a highly complex biological health problem with a high risk of chronic diseases, including type 2 diabetes, atherosclerosis, chronic bronchitis or emphysema, cancer and Alzheimer's disease. Particularly, age-related turnover in adipose tissue is a major contributor to metabolic syndromes and shortened lifespan. Adipocytes undergo senescence in early stage, which results in adipose tissue metabolic dysfunction, redistribution, and inflammation. The well-established association between DNA methylation (DNAm) and aging has been observed in the past few decades. Indeed, age-related alteration in DNAm is highly tissue-specific. This review intends to summarize the advancements how DNAm changes coupled with aging process in adipose tissue, by which DNAm regulates cellular senescence, metabolic function, adipokine secretion and beiging process in adipocytes. Elucidation of the effect of DNAm on adipose aging would have great potential to the development of epigenetic therapeutic strategies against aging-related diseases in clinical settings.

Survival Analysis of COVID-19 Patients With Symptoms Information by Machine Learning Algorithms

In this study, a survival analysis of the time to death caused by coronavirus disease 2019 is presented. The analysis of a dataset from the East Asian region with a focus on data from the Philippines revealed that the hazard of time to death was associated with the symptoms and background variables of patients. Machine learning algorithms, i.e., dimensionality reduction and boosting, were used along with conventional Cox regression. Machine learning algorithms solved the diverging problem observed when using traditional Cox regression and improved performance by maximizing the concordance index (C-index). Logistic principal component analysis for dimensionality reduction was significantly efficient in addressing the collinearity problem. In addition, to address the nonlinear pattern, a higher C-index was achieved using extreme gradient boosting (XGBoost). The results of the analysis showed that the symptoms were statistically significant for the hazard rate. Among the symptoms, respiratory and pneumonia symptoms resulted in the highest hazard level, which can help in the preliminary identification of high-risk patients. Among various background variables, the influence of age, chronic disease, and their interaction were identified as significant. The use of XGBoost revealed that the hazards were minimized during middle age and increased for younger and older people without any chronic diseases, with only the elderly having a higher risk of chronic disease. These results imply that patients with respiratory and pneumonia symptoms or older patients should be given medical attention.

Feasibility of promoting physical activity using mHEALTH technology in rural women: the step-2-it study

BackgroundRural women are more likely to be obese and have a higher risk for chronic disease than their non-rural counterparts. Inadequate physical activity (PA) at least in part contributes to this increased risk. Rural women face personal, social and environmental barriers to PA engagement. Interventions promoting walking among rural women have demonstrated success; however, few of these studies use text messaging to promote PA.MethodsStep-2-It was a pilot study to assess the feasibility, acceptability, and effectiveness of text-messaging combined with a pedometer to promote PA, specifically walking among English-speaking women, aged 40 and older, living in a rural, northwest Illinois county. Enrolled participants completed baseline assessments, received pedometers and two types of automated text messages: motivational messages to encourage walking, and accountability messages to report pedometer steps. Participants engaged in 3, 6, 9, and 12-week follow-ups to download pedometer data, and completed post-intervention assessments at 12 weeks.ResultsOf the 44 enrolled participants, 35 participants (79.5%) completed the intervention. Among completers, the proportion meeting PA guidelines increased from 31.4% (11/35) at baseline to 48.6% (17/35) at post-intervention, those with no PA decreased from 20% (7/35) to 17.1% (6/35). During weeks 1-12, when participants received motivational text messages, average participant daily step count was 5926 ± 3590, and remained stable during the intervention. Pedometer readings were highly correlated with self-reported steps (r = 0.9703; p < 0.001).ConclusionStep-2-It was a feasible and acceptable walking intervention for older rural women. Technology, including text messaging, should be investigated further as an enhancement to interventions for rural women.Trial Registration on Clinicaltrials.gov: NCT04812756, registered on March 22, 2021

Accelerating Evaluation of Financial Incentives for Fruits and Vegetables: A Case for Shared Measures.

Food insecurity, or lack of consistent access to enough food, is associated with low intakes of fruits and vegetables (FVs) and higher risk of chronic diseases and disproportionately affects populations with low income. Financial incentives for FVs are supported by the 2018 Farm Bill and United States (U.S.) Department of Agriculture’s Gus Schumacher Nutrition Incentive Program (GusNIP) and aim to increase dietary quality and food security among households participating in the Supplemental Nutrition Assistance Program (SNAP) and with low income. Currently, there is no shared evaluation model for the hundreds of financial incentive projects across the U.S. Despite the fact that a majority of these projects are federally funded and united as a cohort of grantees through GusNIP, it is unclear which models and attributes have the greatest public health impact. We explore the evaluation of financial incentives in the U.S. to demonstrate the need for shared measurement in the future. We describe the process of the GusNIP NTAE, a federally supported initiative, to identify and develop shared measurement to be able to determine the potential impact of financial incentives in the U.S. This commentary discusses the rationale, considerations, and next steps for establishing shared evaluation measures for financial incentives for FVs, to accelerate our understanding of impact, and support evidence-based policymaking.

Physical activity and exercise status of adult residents with high risk of chronic diseases in Beijing in 2017

To understand the physical activity and regular exercise status and influencing factors of people with high risk of chronic diseases among Beijing residents, and to provide science basis for health education strategies and intervention measures. 13 200 participants aged 18-79 were selected by stratified cluster sampling method for questionnaire survey in 2017.3448 participants without hypertension, diabetes and dyslipidemia met the criteria of high risk population. The metabolic equivalent of physical activity was calculated by referring to the summary of physical activity in the United States and the global physical activity questionnaire. 1794 male(52.0%) and 1654 female(48.0%) are included in this study. 862(25.0%) are 18-29 years old, 778(22.6%) are 30-39 years old, 640(18.6%) are 40-49 years old, 709(20.6%) are 50-59 years old, and 193(13.3%) are 60-79 years old. 684 participants(18.6%) are low physical activity level, 1480 participants(42.9%) are medium level and 1284 respondents(37.2%) are high level. The rate of never exercising is 60.2%. Multivariate analysis shows female(OR=1.32, 95%CI 1.11-1.55), aged 40-49(OR=1.34, 95%CI 1.04-1.72) and aged 50-59(OR=1.76, 95%CI 1.36-2.28) participants are likely to have high level physical activity. Participants with high education level(OR=0.78, 95%CI 0.66-0.93) and insufficient intake of fruits and vegetables(OR=0.73, 95%CI 0.64-0.84) are likely to have low physical activity level. Female(OR=1.46, 95%CI 1.22-1.76), participants with insufficient intake of fruits and vegetables(OR=1.44, 95%CI 1.24-1.69) are likely never to exercise. Participants with high education level(OR=0.46, 95%CI 0.38-0.55), high school education(OR=0.63, 95%CI 0.53-0.75), no job(OR=0.67, 95%CI 0.56-0.81) are likely to exercise. The population with high risk of chronic diseases in Beijing City was lack of physical activity. Gender, age, education level, fruit and vegetable intake are the influencing factors of physical activity level, while gender, fruit and vegetable intake, education level, marriage, employment and fruit and vegetable intake are the influencing factors of exercise.

Sleep and circadian rhythms: pillars of health-a Keystone Symposia report.

The human circadian system consists of the master clock in the suprachiasmatic nuclei of the hypothalamus as well as in peripheral molecular clocks located in organs throughout the body. This system plays a major role in the temporal organization of biological and physiological processes, such as body temperature, blood pressure, hormone secretion, gene expression, and immune functions, which all manifest consistent diurnal patterns. Many facets of modern life, such as work schedules, travel, and social activities, can lead to sleep/wake and eating schedules that are misaligned relative to the biological clock. This misalignment can disrupt and impair physiological and psychological parameters that may ultimately put people at higher risk for chronic diseases like cancer, cardiovascular disease, and other metabolic disorders. Understanding the mechanisms that regulate sleep circadian rhythms may ultimately lead to insights on behavioral interventions that can lower the risk of these diseases. On February 25, 2021, experts in sleep, circadian rhythms, and chronobiology met virtually for the Keystone eSymposium "Sleep & Circadian Rhythms: Pillars of Health" to discuss the latest research for understanding the bidirectional relationships between sleep, circadian rhythms, and health and disease.

Association of Emulsifier and Highly Processed Food Intake with Circulating Markers of Intestinal Permeability and Inflammation in the Cancer Prevention Study-3 Diet Assessment Sub-Study

Compelling animal studies report increased intestinal permeability, inflammation, and colorectal carcinogenesis with exposure to certain emulsifiers commonly added to processed foods, but human data are lacking. Highly processed food consumption is also associated with obesity and higher risk of chronic diseases. We cross-sectionally examined the association of emulsifier and highly processed food consumption estimated from six 24-h dietary recalls among 588 U.S. men and women over one year, with biomarkers of intestinal permeability and inflammation measured from two fasting blood samples collected six months apart. In multivariable-adjusted generalized linear models, greater emulsifier intake (g/d) was not associated with antibodies to flagellin (P-trend = 0.88), lipopolysaccharide (LPS) (P-trend = 0.56), or the combined total thereof (P-trend = 0.65) but was positively associated with an inflammatory biomarker, glycoprotein acetyls (GlycA) (P-trend = 0.02). Highly processed food intake (% kcal/d) was associated with higher anti-LPS antibodies (P-trend = 0.001) and total anti-flagellin and anti-LPS antibodies (P-trend = 0.005) but not with other biomarkers, whereas processed food intake expressed as % g/d was associated with higher GlycA (P-trend = 0.02). Our findings suggest that, broadly, highly processed food consumption may be associated with intestinal permeability biomarkers, and both emulsifier and highly processed food intakes may be associated with inflammation. Additional studies are warranted to further evaluate these relationships. Supplemental data for this article is available online at https://doi.org/10.1080/01635581.2021.1957947

Feasibility of an Internet-Based Intervention to Promote Exercise for People With Spinal Cord Injury: Observational Pilot Study.

BackgroundPeople with spinal cord injury (SCI) are less likely to be physically active and have higher chronic disease risk than those in the general population due to physical and metabolic changes that occur postinjury. Few studies have investigated approaches to promote increased physical activity (PA) for people with SCI despite evidence that they face unique barriers, including lack of accessible transportation and exercise equipment. To address these obstacles, we adapted an evidence-based phone-delivered intervention that promoted increased PA among people with SCI into a web-based platform, titled the Workout on Wheels internet intervention (WOWii). The adapted program provides participants with weekly skill-building information and activities, basic exercise equipment, and ongoing support through weekly group videoconferencing.ObjectiveThis pilot study was conducted to assess the feasibility of using a web-based and virtual format to deliver the WOWii program in a randomized controlled trial.MethodsWe assessed the feasibility of the web-based program by delivering an abbreviated, 4-week version to 10 participants with SCI. Rates of weekly videoconference attendance, activity completion, and exercise activity as tracked by an arm-based activity monitor were recorded for all participants.ResultsParticipants averaged 3.3 of 4 (83%) weekly group videoconferences attended, 3.4 of 4 (85%) web-based module activities completed, and 2.3 of 4 (58%) weeks of using the arm-based activity monitor. The majority of the sample (9/10, 90%) synced their arm-based PA monitor at least once, and overall engagement as an average of each component across the 4 weeks was 75%.ConclusionsThe intervention had sufficiently high levels of engagement to be used in a full randomized controlled trial to test its effectiveness in improving levels of PA among people with SCI. The knowledge we gained from this pilot study informed improvements that were made in the full randomized controlled trial.

Change in Diet Quality and Meal Sources During the COVID-19 Pandemic in a Subset of Men and Women in the Cancer Prevention Study-3

ObjectivesThe massive spread of the novel coronavirus SARS-CoV2 (COVID-19) and subsequent restrictive measures caused disruptions in daily routines and behaviors, including changes in diet that may have consequences on immediate health and longer term risk of chronic disease. Our objective was to assess two-year changes in diet quality among subgroups of the Cancer Prevention Study-3 (CPS-3) cohort.MethodsIn August 2020, an online COVID-19 survey that assessed food group intakes, meal sources, and COVID-related questions was completed by a subgroup of 2,335 CPS-3 participants. Paired t-tests evaluated reported change in behaviors from 2018 to 2020. A diet quality score assigned higher points for greater frequency of foods recommended by cancer prevention guidelines, and lower points for foods that are not recommended.ResultsWhile diet quality improved slightly, on average, from 2018 to 2020, consumption of component food groups decreased (P < 0.001),with the greatest decreases in vegetables and whole grains. The greatest decrease in vegetable intake occurred in Black participants, as well as participants who gained weight. On average, Asian/Pacific Islander participants increased fruit consumption. Participants who lost ≥20 pounds had the greatest decrease in refined grain consumption and greatest improvements in diet quality. Low diet quality scores during the pandemic were associated with being male, current smoking, less education, lower physical activity, higher BMI, and weight gain of ≥20 pounds since 2018. Participants who worried about food insecurity, were at high risk of COVID-19 complications, and reported more COVID-related stressors also had lower scores. Changes in diet quality did not appear to vary by other demographic factors. On average, total alcohol intake decreased in most groups examined. Frequency of meals from all sources decreased (P < 0.001), and the greatest decreases were observed in full-service restaurants and prepared ready-to-eat meals.ConclusionsUndesirable changes in diet during the pandemic, particularly decreases in vegetables and whole grains, may contribute to weight gain, poor metabolic health, and subsequent higher risk of chronic disease.Funding SourcesThe American Cancer Society funds the creation, maintenance, and updating of the Cancer Prevention Study-3 Cohort.

The health and socioeconomic costs of exposure to soil pollution: evidence from three polluted mining and industrial sites in Europe

This article aims at providing a better understanding of the health and socioeconomic costs induced by soil pollution exposure. We conduct quantitative surveys in households living near mining and/or industrial sites in France, Spain, and Portugal, as well as those located in cleaner neighboring areas. We employ a complementary estimation approach based on ordinary least squares, instrumental variables, and propensity score matching. Our results confirm significant life-long health risks for residents of polluted areas compared to those in control areas. We find lower birth weight and lower childhood health status, as well as a higher risk of chronic disease in adulthood and higher premature mortality. Regarding the socioeconomic costs, we find higher rates of school absenteeism and health service demand among residents from polluted areas compared to control areas. Furthermore, we observe heterogeneous effects according to sociodemographic characteristics. As expected, children and the elderly are the most sensitive age groups; in addition, materially deprived and uneducated households are particularly vulnerable to pollution. More surprisingly, there is some evidence of higher vulnerability of educated households with regard to birth outcomes. Our results have important implications for public policy: they allow alerting about actually observed health risks in the exposed areas, but they also call for designing awareness campaigns and remedial strategies that are targeted towards the most vulnerable.

Living Well with Lifestyle Medicine: A group consultation approach to delivering Lifestyle Medicine Intervention in Primary Care

AbstractIntroductionIncreasing prevalence of chronic disease is raising demands on the healthcare system, and evidence‐based cost‐effective ways to address these are needed. This project piloted a novel approach of delivering lifestyle medicine in general practice by providing a holistic lifestyle medicine programme to patients at high risk of chronic diseases.MethodsEleven patients at high risk of chronic disease participated in a 6‐week programme of General Practitioner (GP)‐led group consultations, which delivered evidence‐based lifestyle education and interventions across all the pillars of lifestyle medicine. Anthropometric data (including weight and body mass index (BMI)) and quality‐of‐life data (using the EuroQol‐5D (EQ‐5D‐5L) tool) and patient's confidence and motivation were assessed at the beginning and end of the programme to assess impact. Cost‐effectiveness was estimated by calculating the cost‐per‐quality‐adjusted‐life‐year (QALY) for the EQ‐5D‐5L data.ResultsSeventy‐three per cent of participants lost weight, with an average weight loss of 1.7 kg confidence interval (CI), –3.46 to –0.02 kg; P = 0.048), which resulted in an average BMI reduction of 0.56 (CI, –1.11 to –0.02; P = 0.043) over 6 weeks. Quality of Life scores show improvement, with EuroQol‐visual analogue scale (EQ‐VAS) score increase of 23 points (CI, +11.82 to +34.18; P = 0.002) and EQ‐5D‐5L scores show reduction in mobility problems, anxiety and depression and pain. Patient's self‐rated confidence and motivation to make healthy lifestyle changes improved significantly over the programme.ConclusionsDelivery of lifestyle medicine intervention via a GP‐led group consultation model results in improvement in patients’ perceived health and well‐being, along with reductions in weight, and reduced problems with mood and pain. Delivery of care in this way is cost‐effective. The positive findings from this pilot‐scale study support investment in a larger study to further develop and explore delivery of lifestyle medicine intervention in this way.

Developmental origins of metabolic diseases.

Almost 2 billion adults in the world are overweight, and more than half of them are classified as obese, while nearly one-third of children globally experience poor growth and development. Given the vast amount of knowledge that has been gleaned from decades of research on growth and development, a number of questions remain as to why the world is now in the midst of a global epidemic of obesity accompanied by the "double burden of malnutrition," where overweight coexists with underweight and micronutrient deficiencies. This challenge to the human condition can be attributed to nutritional and environmental exposures during pregnancy that may program a fetus to have a higher risk of chronic diseases in adulthood. To explore this concept, frequently called the developmental origins of health and disease (DOHaD), this review considers a host of factors and physiological mechanisms that drive a fetus or child toward a higher risk of obesity, fatty liver disease, hypertension, and/or type 2 diabetes (T2D). To that end, this review explores the epidemiology of DOHaD with discussions focused on adaptations to human energetics, placental development, dysmetabolism, and key environmental exposures that act to promote chronic diseases in adulthood. These areas are complementary and additive in understanding how providing the best conditions for optimal growth can create the best possible conditions for lifelong health. Moreover, understanding both physiological as well as epigenetic and molecular mechanisms for DOHaD is vital to most fully address the global issues of obesity and other chronic diseases.

Diet quality, assessed by the Healthy Eating Index-2010, and exercise associated factors of obesity: a cross-sectional study

Introduction: Certain weight management methods may be associated with unhealthy dietary intakes, skewing toward certain dietary components and lacking others. Management of weight should not ignore the quality of the diet, as both obesity and poor diet are associated with higher risk of chronic disease. Objective: To conduct a diet quality and exercise scan and observe their repercussion on BMI, in adults from Spain, Portugal, Uruguay and Mexico. Material and methods:An observational retrospective cohort study was designed, with 1181 adults aged 18-65 years. HEI-2010 score was used to assess diet quality. Data on type, days a week and hours/day of exercise, and participant’s anthropometric measures were collected.Results: The mean HEI-2010 score was 65.21. There were no statistically significant differences between HEI-2010 score and BMI [p=0.706], BMI and days of exercise per week [p=0.151], BMI and hours/day of exercise [p=0.590] and BMI and being active [&gt;3 days/week] [p=0.106]. On the contrary, overall exercise influenced BMI significantly [p&lt;0.001]. Conclusions: Dietary patterns may help to prevent weight gain and fight overweight and obesity. This study, however, did not observe associations between the quality of the diet nor specifics of exercise with lower BMIs. The quality of the diet of adults in Spain, Portugal, Uruguay and Mexico fell short of recommendations.

Are Irregular Menstrual Cycles Associated with Higher Risk for Premature Death

Irregular menstrual cycles have been associated with higher risk for chronic diseases such as coronary heart disease and cancer, but whether such

How Do Positive Psychological Constructs Affect Physical Activity Engagement Among Individuals at High Risk for Chronic Health Conditions? A Qualitative Study.

Positive psychological constructs (eg,optimism, positive affect) may help people engage in physical activity, though the details of these relationships and their directionality have not been studied in depth in people with cardiovascular risk factors. The objectives of this study were to use qualitative research to explore the relationships of positive psychological constructs with physical activity among people with metabolic syndrome. Participants with metabolic syndrome and low physical activity from an academic medical center completed semistructured phone interviews about associations between physical activity and positive psychological constructs, and perceptions about benefits, motivation, and barriers to physical activity. The participants (n = 21) were predominantly older (mean age = 63y) white (95.2%) women (61.9%). Engaging in physical activity was commonly associated with enjoyment, energy, relaxation, accomplishment, and determination. Experiencing positive psychological constructs like enjoyment, energy, connectedness, optimism, and determination also helped them engage in physical activity. Perceived benefits, facilitators, and barriers of physical activity engagement were noted. The participants at high risk for chronic diseases described many specific positive psychological constructs that both promote and result from physical activity. Testing ways to increase positive psychological constructs may be a novel way to help people at high risk of chronic diseases become more active.

The Association Between Socioeconomic Status And Access To Physical Activity Related Built Environment In Children

Minorities and those with lower socioeconomic status (SES) are at higher risk for chronic diseases compared to their Caucasian counterparts and those with higher SES. Establishing life-long physical activity (PA) behavior in childhood could lower the risk for chronic disease in adulthood. Access to opportunities for PA in the built environments is associated with increased PA behavior in children. Understanding patterns of access to these opportunities for minority and low SES children would be useful in developing interventions to increase PA in these populations. PURPOSE: To investigate the relationship among race, SES, proximity to public parks for children and adolescents in a mid-sized city. METHODS: ArcGIS Online was used to map public parks with 10-minute walking buffers, census track-level demographics (race of children and adolescents [≤ 19 yrs], household poverty status, and population density). Central city neighborhoods were also mapped. Partial correlations between the variables were performed, controlling for all other variables. Hierarchical cluster analysis identified homogeneous census tracts with regard to race, SES, park proximity, and population density. One-way ANOVA measured differences in the variables used to construct the clusters. Significance was set at p<0.05. RESULTS: Poverty correlated with black race (r2=0.60, p<0.001) and park proximity (r2=0.53, p=0.54), but there was no significant correlation between race and park proximity. Population density correlated with black race (r2=0.63, p<0.001), but not with any other variables. Two census track clusters were identified. Parks in cluster 1 corresponded with neighborhoods centrally located in the city. Compared to cluster 2, cluster 1 showed higher percentages of households below the poverty level (36.1±13.2 vs 4±8.6), children and adolescents of black race (63.4±18.6 vs 30.3±18.3), and children and adolescents living within 10-minute walking distance to a park (76.7±16.7 vs 8.0±11.4). CONCLUSIONS: Abundant proximity to parks may provide opportunities for physical activity interventions for at-risk children and adolescents in urban areas. Future directions should include the investigation of additional aspects of access in these subgroups such as patterns of PA-promoting park amenities.

Provider Counseling About and Risk Perception for Future Chronic Disease Among Women with Gestational Diabetes and Preeclampsia.

Background: Women diagnosed with gestational diabetes or preeclampsia are at a greater risk of developing future type 2 diabetes mellitus, high blood pressure, and cardiovascular disease. Increased perception of future chronic disease risk is positively associated with making health behavior changes, including in pregnant women. Although gestational diabetes is a risk factor for type 2 diabetes, few women have heightened risk perception. Little research has assessed receipt of health advice from a provider among women with preeclampsia and its association with risk perception regarding future risk of high blood pressure and cardiovascular disease. Among women with recent diagnoses of preeclampsia or gestational diabetes, we assessed associations between receipt of health advice from providers, psychosocial factors, and type of pregnancy complication with risk perception for future chronic illness. Methods: We conducted a cross-sectional analysis among 79 women diagnosed with preeclampsia and/or gestational diabetes using surveys and medical record abstraction after delivery and at 3 months postpartum. Results: Overall, fewer than half of the 79 women with preeclampsia and gestational diabetes reported receiving health advice from a provider, and women with preeclampsia were significantly less likely to receive counseling as compared with women with gestational diabetes (odds ratio 0.23). We did not identify a difference in the degree of risk perception by pregnancy complication or receipt of health advice. There were no significant differences in risk perception based on age, race, education, or health insurance coverage. Conclusions: We demonstrated that women with preeclampsia and gestational diabetes are not routinely receiving health advice from providers regarding future chronic disease risk, and that women with preeclampsia are less likely to be counseled on their risk, compared with women with gestational diabetes. Provider and patient-centered interventions are needed to improve postpartum care and counseling for women at high risk for chronic disease based on recent pregnancy complications.

The Relationship Between Inflammatory Cytokines and Calciotropic Hormones in South Asian and Caucasian Men

Abstract Objectives The study objective was to identify the differences in inflammatory profile, and possible predictors of vitamin D and parathyroid hormone (PTH) concentrations between South Asian Indians (SAIs) and Caucasians. Methods Healthy SAIs and Caucasian men, who were 22 to 50 years of age, were recruited. Anthropometric measurements including body composition using Dual X-Ray Energy Absorptiometry and serum 25 hydroxy-vitamin D (25(OH)D), PTH, Matrix metallopeptidase 9 (MMP-9), C-terminal peptide (CTX), osteocalcin, insulin, adiponectin, and serum glucose concentrations were obtained. Independent t-test was used to report the mean differences between groups. Spearman correlation, and linear regression were used to identify possible predictors of 25(OH)D, and PTH levels. A P-value of less than 0.05 was considered significant. Results 28 SAIs and 28 Caucasians completed the study. Both groups did not significantly differ in their age and BMI. The mean 25(OH)D levels were 22.3 ± 6.6 ng/mL and 31.96 ± 9 ng/mL for SAIs and Caucasians, (P &amp;lt; 0.01). The mean PTH levels were 65.0 ± 26.7pg/mL, and 53.5 ± 30.1pg/mL for SAIs and Caucasians, (P &amp;gt; 0.05). The mean adiponectin levels were significantly lower among SAIs (2.26 ± 1.8 ng/mL) compared to the Caucasians (71 ± 2.4 ng/mL), (P &amp;lt; 0.001). The MMP-9 levels were significantly higher in the Caucasians (P = 0.050). The regression analysis found both serum 25(OH)D and insulin concentrations as best predictors of PTH levels in SAIs, while MMP-9 level was the best predictor of PTH levels in Caucasians. Serum glucose and PTH levels were best predictors of 25(OH)D levels in SAIs, while adiponectin level was the best predictor of the 25(OH)D in Caucasians. Conclusions The differences in serum levels of 25(OH)D, MMP-9, and adiponectin between the two ethnic groups could explain why SAIs have a higher risk for chronic diseases. Future studies should consider improving vitamin D and adiponectin levels among SAIs via vitamin or minerals supplements that could improve their cardiometabolic health. Funding Sources Drexel University.