Long-term Risk Of Chronic Disease Research Articles

HEALTH AND WELL-BEING ACROSS ECOLOGICAL SYSTEMS AND TIME IN MID LIFE AND LATE ADULTHOOD

Abstract Health and well-being are shaped by peoples’ experiences and ecological contexts (Bronfenbrenner, 2005), reflecting the influence of complex person-context relationships. For example, experiences (e.g., daily stressors, early childhood adversity) occur within microlevel (e.g., marital relationships, neighborhoods) and macrolevel (e.g., societal inequalities) contexts, impacting both daily well-being and healthy aging. Further, a robust literature highlights the significance of naturally occurring everyday experiences for a range of health outcomes, underscoring how daily experiences have immediate and lasting effects on individual physical and cognitive health and psychological well-being. Drawing on Bronfenbrenner’s Ecological Model, the current symposium features novel research examining health and well-being outcomes across diverse ecological systems and time scales across midlife and old age, with the goal of articulating how innovative approaches for studying person-context interactions can be leveraged to understand both proximal and long-term health and well-being. Polenick and colleagues will examine associations between daily negative and positive events and well-being among heterosexual married couples living with early-stage dementia. Cichy et al. will examine gender differences in the prospective effects of daily stress processes on long-term chronic disease risk in midlife and later life. Next, Turner and Mogle will examine how positive and negative affect mediate the associations between daily memory lapses and psychological well-being. Finally, Choi, Munoz, Scott, and Sliwinski will examine whether current positive (i.e., neighborhood cohesion) and negative (i.e., neighborhood violence) neighborhood contexts moderate the effect of childhood stress exposure on cognitive function in adulthood. Robert Stawski will synthesize the presentations and offer insights for future research.

Breastfeeding duration and subsequent risk of mortality among US women: A prospective cohort study.

SummaryBackgroundBreastfeeding has been associated with a reduced maternal long-term risk of chronic diseases, but its association with mortality is poorly known.MethodsWe included 166,708 female United States (US) nurses from the Nurses’ Health Study (1986-2016) and the Nurses’ Health Study II (1989-2019) who experienced at least one pregnancy lasting at least six months across their reproductive lifespan. Hazard ratios and 95% confidence intervals (CI) for mortality according to lifetime breastfeeding duration were estimated with time-dependent Cox proportional hazards regression models.FindingsDuring 4,705,160 person-years of follow-up, 36,634 deaths were documented in both cohorts, including 9880 from cancer and 7709 from cardiovascular disease (CVD). Lifetime total breastfeeding duration was associated with a lower subsequent risk of all-cause mortality in a non-linear manner (p-value for non-linearity=0.0007). The pooled multivariable-adjusted hazard ratios of all-cause mortality were 0.95 (95% CI: 0.92 to 0.98), 0.94 (95% CI: 0.91 to 0.98), 0.93 (95% CI: 0.90 to 0.97), and 0.93 (95% CI: 0.89 to 0.97), respectively, for women reporting lifetime total breastfeeding duration of 4–6, 7–11, 12–23, and ≥24 months, compared to women who breastfed for ≤3 months over their reproductive lifespan. Cause-specific analysis showed a similar pattern of non-linear inverse associations between lifetime total breastfeeding duration and CVD and cancer mortality (both p-values for non-linearity <0.01). There was no evidence of interactions between breastfeeding duration and pre-pregnancy lifestyle factors on mortality risk.InterpretationParous women with longer lifetime breastfeeding duration had a modestly lower risk of mortality.FundingThe National Institutes of Health grants.

Nutrition and Metabolic Adaptations in Physiological and Complicated Pregnancy: Focus on Obesity and Gestational Diabetes.

Pregnancy offers a window of opportunity to program the future health of both mothers and offspring. During gestation, women experience a series of physical and metabolic modifications and adaptations, which aim to protect the fetus development and are closely related to both pre-gestational nutritional status and gestational weight gain. Moreover, pre-gestational obesity represents a challenge of treatment, and nowadays there are new evidence as regard its management, especially the adequate weight gain. Recent evidence has highlighted the determinant role of nutritional status and maternal diet on both pregnancy outcomes and long-term risk of chronic diseases, through a transgenerational flow, conceptualized by the Development Origin of Health and Diseases (Dohad) theory. In this review we will analyse the physiological and endocrine adaptation in pregnancy, and the metabolic complications, thus the focal points for nutritional and therapeutic strategies that we must early implement, virtually before conception, to safeguard the health of both mother and progeny. We will summarize the current nutritional recommendations and the use of nutraceuticals in pregnancy, with a focus on the management of pregnancy complicated by obesity and hyperglycemia, assessing the most recent evidence about the effects of ante-natal nutrition on the long-term, on either maternal health or metabolic risk of the offspring.

Predicting Hawaiian Youth's Physical Activity and Fruit and Vegetable Consumption Behaviors: A 10-Year Cohort Study.

Background: Health behaviors in childhood and adolescence are implicated in health behaviors and chronic disease risk in adulthood for the majority of the US population. However, little is known about these relationships in Hawaiian youth. This study investigated the extent to which childhood physical activity (PA) and fruit and vegetable consumption behaviors predicted later behaviors across a 10-year period in Hawaiian youth. Methods: Three cohorts of fourth- to sixth-grade students who participated in an elementary after-school program (Fun 5) provided baseline data (Y1-data collected between 2003 and 2007), 5-year (Y5-data collected between 2008 and 2012), and 10-year (Y10-data collected between 2013 and 2017) follow-up surveys. Demographic, PA, and fruit and vegetable consumption measures were completed at all 3 time points. Bivariate and multiple regressions were computed in 2018. Results: Y1 and Y5 behavior predicted PA in young adulthood. For fruit and vegetable consumption, Y1 behavior predicted Y5 behavior but not Y10 behavior, and Y5 behavior predicted Y10 behaviors. Conclusions: Similar to mainland US youth, it is important to address PA and nutrition early in the life span for Hawaiian youth to increase long-term preventive health behaviors and reduce long-term chronic disease risk.

Path Analysis on Life Course Factors Affecting Overweight and Obesity in Children Aged 2 to 5 Years Old in Surakarta

Background: Globally, prevalence of obesity in children under 5 years old has been increasing from 32 million in 1990 to 42 million in 2014. Indonesia ranks highest in the number of obesity cases in South East Asia with prevalence of 11.5% in 2013. However, child overweight and obesity have not been the focus of health problems in Indonesia. Early intervention and prevention of child obesity can reduce long-term risk of chronic diseases in adulthood. This study aimed to analyze the life course factors affecting overweight and obesity in children aged 2 to 5 years old in Surakarta.Subjects and Method: This was an analytic observational study with case control design. The study was conducted in 5 community health centers, Surakarta, from September to October, 2017. A total sample of 150 children aged 2 to 5 years old was selected using fixed disease sampling. The dependent variable was overweight or obesity. The independent variables were nutrition intake, exclusive breastfeeding, starting age of complementary feeding, physical activity, birthweight, age of gestation, sectio cesarea labor, maternal body mass index, and maternal job. Physical activity data was measured using Pre PAQ questionnaire. Other data were collected using a set of questionnaire and maternal and child health monitoring book. The data were analyzed by path analysis.Results: Overweight and obesity in children aged 2 to 5 years old were positively affected by over nutrition intake (b= 1.9; 95% CI= 0.15 to 3.60; p=0.033), high maternal body mass index (b= 2.0; 95% CI= 0.51 to 3.42; p=0.008), and sectio cesarean birth (b= 2.1; 95% CI= 0.56 to 3.73; p=0.008). Overweight and obesity in children aged 2 to 5 years old were negatively affected by normal birthweight (b= -2.2; 95% CI= -4.28 to -0.19; p=0.032), exclusive breastfeeding (b= -2.0; 95% CI= -3.60 to -0.39; p=0.015), timely starting age of complementary feeding (b= -1.3; 95% CI= -2.80 to 0.11; p=0.072), and high physical activity (b= -3.0; 95% CI= -4.63 to -1.37; p=0.001). Birthweight was positively affected by age of gestation (b= 4.2; 95% CI= 1.99 to 6.32; p=0.001) and was negatively affected by maternal body mass index (b= -1.1; 95% CI= -2.11 to -0.13; p=0.025). Exclusive breastfeeding was negatively affected by working outside the house (b= -1.4; 95% CI= -2.10 to -0.72; p= 0.001).Conclusion: Overweight and obesity in children aged 2 to 5 years old are positively affected by over nutrition intake, high maternal body mass index, and sectio cesarean birth. Overweight and obesity in children aged 2 to 5 years old are negatively affected by normal birthweight, exclusive breastfeeding, timely starting age of complementary feeding, and high physical activity.Keyword: life course factors, overweight, obesity, path analysis.Correspondence: Uyunun Nudhira. Masters Program in Public Health, Sebelas Maret University, Jl. Ir. Sutami 36 A, Surakarta 57126, Central Java. Email: uyununnudhira14@gmail.com. Mobile: +6285253781714Journal of Epidemiology and Public Health (2017), 2(3): 267-283https://doi.org/10.26911/jepublichealth.2017.02.03.08

The effect of weight management interventions that include a diet component on weight-related outcomes in pregnant and postpartum women: a systematic review protocol.

Review question/objective What are the effects of weight management interventions that include a diet component on weight-related outcomes in pregnant and postpartum women? The primary objective of this systematic review is to evaluate the effectiveness of weight management interventions which include a diet component and are aimed at limiting gestational weight gain and postpartum weight retention in women. The second objective of this systematic review is to investigate included intervention components with respect to effect on weight-related outcomes. This may include, but is not limited to: length of intervention, use of face-to-face counselling, group or individual consultations, use of other interventions components including exercise, use of goals and use of support tools like food diaries, coaching , including email or text message support. Inclusion criteria Types of participants Participants of interest are pregnant or post-partum adult females (18 years and over), from all pre-pregnancy BMI categories. Women will be included if they have co-morbidities of gestational diabetes or diabetes; all other medical conditions will be excluded. Types of interventions Studies will be included if the weight management interventions include a dietary component and have an objective of determining the relationship with antenatal and/or postpartum weight change. The interventions must have been conducted across the antenatal or postpartum period, with intervention initiation at any point up to six weeks after delivery. Interventions will be compared with usual care, wait-list controls or alternative intervention component or intensity. Types of outcomes This review will consider studies that include body weight as the primary outcome, measured either during pregnancy and/or postpartum. Weight change outcomes reported as weight (kg or lb), Body Mass Index, waist or hip circumference and/or percentage body fat will be included. Adverse outcomes will be documented if reported.

Pregnancy-induced hypertension and diabetes and the risk of cardiovascular disease, stroke, and diabetes hospitalization in the year following delivery.

Although pregnancy events predict the long-term risk of chronic disease, little is known about their short-term impact because of the rarity of clinical events. We examined hospital discharge diagnoses linked to birth certificate data in the year following delivery for 849,639 births during 1995-2004 in New York City, New York. Adjusted odds ratios characterized the relationship between pregnancy complications and subsequent hospitalization for cardiovascular disease, stroke, and diabetes. Gestational hypertension was related to heart failure (adjusted odds ratio = 2.6, 95% confidence interval: 1.5, 4.5). Preeclampsia was related to all of the outcomes considered except type 1 diabetes, with adjusted odds ratios ranging from 2.0 to 4.1. Gestational diabetes was strongly related to the risk of subsequent diabetes (for type 1 diabetes, adjusted odds ratio = 40.4, 95% confidence interval: 23.8, 68.5; for type 2 diabetes, adjusted odds ratio = 22.6, 95% confidence interval: 16.9, 30.4) but to no other outcomes. The relationship of pregnancy complications to future chronic disease is apparent as early as the year following delivery. Moreover, elucidating short-term clinical outcomes offers the potential for etiological insights into the relationship between pregnancy events and chronic disease over the life course.

The effect of intra‐uterine growth restriction on blood lipids and response to exercise training

To determine if a small body size at birth is associated with an unfavorable metabolic profile and a reduced response to exercise training in young adults. Thirty-six college students, all singletons born to term, participated. Subjects were defined as either high ponderal index (HIGHPI) or low ponderal index (LOWPI). LOWPI was defined as below the 10th percentile of the PI-for-gestational age distribution. HIGHPI was defined as greater than the 10th percentile. Subject groups were matched pair-wise on age, sex, BMI, and pretraining physical activity level. Subjects completed an 8-week aerobic exercise program. Pre- and post-training measurements included a blood lipid profile. The LOWPI group, when compared to the HIGHPI group, exhibited higher total (183.6 mg dl(-1) vs. 150.9, P = 0.04) and LDL cholesterol (114.8 mg dl(-1) vs. 80.2, P = 0.019) values prior to exercise training. After training, these values decreased in the LOWPI group, eliminating the group difference. Various blood lipid ratios were more favorable for the HIGHPI group, both before and after training. The inclusion of maternal smoking as a covariate attenuated group differences for pretraining TChol, pre-training TG:HDL, and post-training HDL cholesterol. An 8-week exercise program corrected some, but not all, of the differences in blood lipid values between the LOWPI and HIGHPI group. The persistent group difference in blood lipid ratios suggests a higher long-term risk of chronic disease in the LOWPI group independent of lifestyle intervention.

Targeting Preschool Children to Promote Cardiovascular Health: Cluster Randomized Trial

BackgroundSchool programs can be effective in modifying knowledge, attitudes, and habits relevant to long-term risk of chronic diseases associated with sedentary lifestyles. As part of a long-term research strategy, we conducted an educational intervention in preschool facilities to assess changes in preschoolers' knowledge, attitudes, and habits toward healthy eating and living an active lifestyle. MethodsUsing a cluster design, we randomly assigned 14 preschool facilities in Bogotá, Colombia to a 5-month educational and playful intervention (7 preschool facilities ) or to usual curriculum (7 preschool facilities ). A total of 1216 children aged 3-5 years, 928 parents, and 120 teachers participated. A structured survey was used at baseline, at the end of the study, and 12 months later to evaluate changes in knowledge, attitudes, and habits. ResultsChildren in the intervention group showed a 10.9% increase in weighted score, compared with 5.3% in controls. The absolute adjusted difference was 3.90 units (95% confidence interval [CI], 1.64-6.16; P <.001). Among parents, the equivalent statistics were 8.9% and 3.1%, respectively (absolute difference 4.08 units; 95% CI, 2.03 to 6.12; P <.001), and among teachers, 9.4% and 2.5%, respectively (absolute difference 5.36 units; 95% CI, −0.29-11.01; P = .06). In the intervened cohort 1 year after the intervention, children still showed a significant increase in weighted score (absolute difference of 6.38 units; P <.001). ConclusionsA preschool-based intervention aimed at improving knowledge, attitudes, and habits related to healthy diet and active lifestyle is feasible, efficacious, and sustainable in very young children.

Body composition in infants: Evidence for developmental programming and techniques for measurement

The consequences of fetal growth retardation remain unclear, in part because they appear to vary between industrialized and developing countries. Data on body composition offer a new opportunity to investigate this issue, and may be of particular value in addressing the controversial role of nutrition in infancy, which has been proposed by some to boost survival, and by others to increase long-term risk of chronic diseases. The uncertainty regarding the effects of post-natal nutrition is presenting challenges to nutritional policy as many countries undergo the nutrition transition, whereby the nutritional status of individuals may shift within the life-course. A theoretical model, building on the thrifty phenotype hypothesis, is presented to clarify how body composition data can address this dilemma. Measurements of body composition can now be obtained in infants and children using several different technologies, indicating that large-scale studies can now be conducted to investigate objectively the association between early growth patterns and later health.