Disease Risk Factors In Adults Research Articles

Associations of childhood 25-hydroxyvitamin D2 and D3 and cardiovascular risk factors in adolescence: prospective findings from the Avon Longitudinal Study of Parents and Children

Studies of the associations of circulating total 25-hydroxyvitamin D (25(OH)D) with cardiovascular disease risk factors in adults have reported inconsistent findings. We aimed to compare prospective associations of two analogues of childhood 25(OH)D (25(OH)D2 and 25(OH)D3) with cardiovascular risk factors measured in adolescence. We examined associations of childhood (ages 7-12 years) 25(OH)D2 and 25-25(OH)D3 with a range of cardiovascular risk factors (blood pressure, fasting lipids, glucose, insulin and C-reactive protein (CRP)) determined in adolescence (mean age 15.4 years). Data were from 2470 participants of the Avon Longitudinal Study of Parents and Children (ALSPAC), a prospective population-based cohort. After adjustments for age, gender, socioeconomic position and BMI, there were no associations of 25(OH)D2 with cardiovascular risk factors. There was a positive association of season-adjusted (and unadjusted) 25(OH)D3 with high-density lipoprotein cholesterol (HDL-C) (mean change per doubling of 25(OH)D3: 0.03 mmol/l; 95% confidence interval (CI): 0.001 to 0.05, p = 0.02) and an inverse association with fasting insulin (relative difference of -4.59% per doubling; 95% CI: -8.37 to -0.59, p = 0.03). Participants with total 25(OH)D concentration <50 nmol/l had 0.04 mmol/l lower HDL-C (95% CI: -0.07 to -0.01) and 5.54% higher fasting insulin (95% CI: 0.82 to 10.47) compared with participants with total 25(OH)D ≥72 nmol/l. In the first prospective study of children/adolescents, we have shown that higher 25(OH)D3 concentrations in childhood are associated with higher levels of HDL-C and lower fasting insulin in adolescence.

The irresistible rise of the Cohort Profile

In recognition that cohort studies are the backbone of epidemiology, the International Journal of Epidemiology’s (IJE’s) Cohort Profile series was launched in December 2004. Then, as now, the purpose of the series was to describe a particular cohort in sufficient detail to enable readers to form collaborations, learn from each other and, where appropriate, maximize the use of existing resources through data sharing. The first cohort profiled was the British Regional Heart Study and in the Editor’s Choice heralding its appearance Shah Ebrahim wrote ‘We plan to profile a cohort study in each issue, . . . ’. Clearly, we underestimated the response. Had we stuck to that original plan, a profile accepted today would have made it into print by 2030. By the end of last year, with an inclusion rate of three profiles per issue, 4100 profiles were already in print. However, with another 50 published online or in the final stages of the submission process, it was obvious a new approach for reducing the time from acceptance to print was overdue. We decided to do two things: revise our instructions to authors and limit the number of full profiles appearing in print. The current instructions can be found at http://mc. manuscriptcentral.com/ije. Slightly more prescriptive than before, they additionally require each profile to include a Summary and a Key Messages box. Whereas the Summary should describe the rationale, methods, data and data access, the Key Messages should highlight the main scientific findings to date. Together, they should provide a succinct overview of the cohort, at the same time as enticing those interested to read the full profile. The Summary and Key Messages of every profile accepted for publication will appear in the print version of the journal. However, as for cohort profile updates, the full version of some profiles will only be published online. The Summary and Key Messages for the first of these, the QSkin Sun and Health Study, appears in this issue. Queensland in Australia has the highest rate of melanoma and skin cancer in the world, and QSkin was set up prospectively to examine the role of environment and host/genetic characteristics in their aetiology. Recruitment to QSkin closed at the end of 2011, with 23 874 women and 19 920 men aged 40–69 years enrolled from the general population of Queensland. On recruitment, 23% of these participants reported a family history of melanoma, 39% the surgical removal of one or more skin cancers and 19%410 skin cancers/ solar keratoses burnt or frozen. In addition to QSkin, this issue of IJE presents full profiles for five cohorts that cover the lifecourse from the pre-natal period, through childhood and adolescence into adulthood. The highly productive Infancia y Medio Ambiente (INMA or Environment and Childhood) Project is of particular personal interest— one of the projects I worked on in my days as a lab technician was the mother to child transfer of pesticides in breast milk. INMA is a network of birth cohorts in Spain that aims to describe exposure to environmental pollutants during pregnancy, at birth and during childhood, and to evaluate their impact and the interaction between pollutants, nutrients and genetic variants on growth, health and development. Focusing on the period from birth to adolescence, the 1987 Finnish Birth Cohort has linked data for all births in Finland in 1987 (460 000) to health registers and registers that provide information on induced abortions, criminality and state benefits. Also founded in 1987, the Ugandan–Canadian TASO-CAN Collaboration follows a nationally representative cohort of 424 000 HIV-infected patients, who initiated combination anti-retroviral therapy with the AIDS support organisation (TASO), the oldest and largest community-based provider in Africa. Findings have been reported on treatment adherence and outcomes across the lifecourse from infancy to old age and have influenced international policies on provision of therapy, for example, in conflict settings. The remaining two cohorts focus on disease risk factors in adulthood. In Australia, the PATH through life project has used data from three cohorts of people born in 1937–41, 1956–60 and 1975– 79 to identify risk factors for the common mental disorders. It has also examined cognitive development, the transition to cognitive impairment and gene–environment interactions in relation to mental health outcomes, and undertaken brain imaging in participants aged460 years. Finally, the Tromso study in Northern Norway, set up to examine risk factors for cardiovascular disease, includes data from440 000 participants in six surveys between 1974 and 2008. The cohort has produced a wealth of innovative findings, an example of Published by Oxford University Press on behalf of the International Epidemiological Association

The impact of childhood obesity on morbidity and mortality in adulthood: a systematic review

The objective of this study was to evaluate the evidence on whether childhood obesity is a risk factor for adult disease, independent of adult body mass index (BMI). Ovid MEDLINE (1948-May 2011), EMBASE (1980-2011 week 18) and the Cochrane Library (1990-2011) were searched for published studies of BMI from directly measured weight and height in childhood (2-19 years) and disease outcomes in adulthood. Data were synthesized in a narrative fashion. Thirty-nine studies (n 181-1.1 million) were included in the review. There was evidence for associations between childhood BMI and type 2 diabetes, hypertension and coronary heart disease. Few studies examined associations independent of adult BMI; these showed that effect sizes were attenuated after adjustment for adult BMI in standard regression analyses. Although there is a consistent body of evidence for associations between childhood BMI and cardiovascular outcomes, there is a lack of evidence for effects independent of adult BMI. Studies have attempted to examine independent effects using standard adjustment for adult BMI, which is subject to over-adjustment and problems with interpretation. Studies that use more robust designs and analytical techniques are needed to establish whether childhood obesity is an independent risk factor for adult disease.

Uric Acid Level and Elevated Blood Pressure in US Adolescents

Uric acid is associated with cardiovascular disease and cardiovascular disease risk factors in adults, including chronic kidney disease, coronary artery disease, stroke, diabetes mellitus, preeclampsia, and hypertension. We examined the association between uric acid and elevated blood pressure in a large, nationally representative cohort of US adolescents, a population with a relatively low prevalence of cardiovascular disease and cardiovascular disease risk factors. Among 6036 adolescents 12 to 17 years of age examined in the 1999-2006 National Health and Nutrition Examination Survey, the mean age was 14.5 years, 17% were obese (body mass index: ≥95th percentile), and 3.3% had elevated blood pressure. Mean serum uric acid level was 5.0 mg/dL, and 34% had a uric acid level ≥5.5 mg/dL. In analyses adjusted for age, sex, race/ethnicity, and body mass index percentile, the odds ratio of elevated blood pressure, defined as a systolic or diastolic blood pressure ≥95th percentile for age, sex, and height, for each 0.1-mg/dL increase in uric acid level was 1.38 (95% CI: 1.16-1.65). Compared with <5.5 mg/dL, participants with a uric acid level ≥5.5 mg/dL had a 2.03 times higher odds of having elevated blood pressure (95% CI: 1.38-3.00). In conclusion, increasing levels of serum uric acid are associated with elevated blood pressure in healthy US adolescents. Additional prospective studies and clinical trials are needed to determine whether uric acid is merely a marker in a complex metabolic pathway or causal of hypertension and, thus, a potential screening and therapeutic target.

Effect of Duck-meat Intake on Adult Disease Risk Factors in Adult Human Males

This study was conducted to evaluate the effects of duck-meat consumption on adult disease risk factors, including body compositions, hematological variables, and serum metabolic and lipid profiles in adult human males. To obtain results, 20 adult males aged 20 to 25 were subjected to a diet of 600 g/day of duck-meat for 4 wk, after which body composition, hematological variables, and serum metabolic and lipid profiles were investigated to determine if there was a relationship between duck-meat consumption and adult disease risk factors. The results revealed that high amounts of duck-meat intake did not negatively alter body indices such as body weight, fat mass, body mass index (BMI), % body fat or waste-to-hip ratio (WHR). Furthermore, there were statistically insignificant changes in the number of blood cells, although this number did increase significantly following intake of duck-meat. Moreover, general decreases in serum metabolic parameters were observed, but none of these changes were significant with the exception of the concentration of blood urea nitrogen (BUN). The serum concentrations of LDL-cholesterol also showed a statistically significant decrease by 5.86%. Therefore, this study suggests that the ingestion of duck-meat not only significantly increased the RBC count but also decreased BUN and LDL-cholesterol concentrations in adult males.

Comparison of Intima-Media Thickness of the Carotid Artery and Cardiovascular Disease Risk Factors in Adults With Versus Without the Down Syndrome

Adults with Down syndrome (DS) residing in large institutional settings possess low levels of atherosclerosis. The purpose of this study was to determine whether community-residing adults with DS possess less atherosclerosis than adults without DS. The second purpose was to examine the relation between cardiovascular disease risk factors and intima-media thickness (IMT), a measure of atherosclerosis, in patients with DS. B-mode images of the left common carotid artery were collected to assess IMT in 52 adults with DS and age-, gender-, and race-matched adults without DS (27 women, 25 men; mean age 42 ± 5 years). Total body fat, blood pressure, fasting lipid profiles, insulin, glucose, C-reactive protein, homocysteine, physical activity, and dietary intake were also assessed. Adults with DS possessed lower IMT (0.43 ± 0.07 vs 0.48 ± 0.09 mm, p <0.001), systolic blood pressure (116 ± 15 vs 125 ± 17 mm Hg, p <0.011), and diastolic blood pressure (59 ± 10 vs 73 ± 9 mm Hg, p <0.001) and higher C-reactive protein (0.58 ± 0.55 vs 0.30 ± 0.42 mg/dl, p <0.003), triglycerides (126.5 ± 55.2 vs 103.8 ± 53.2 mg/dl, p <0.048), and total body fat (37.8 ± 10.2% vs 32.4 ± 11.2%, p <0.002) than controls. Male gender (p <0.001) and physical activity (p = 0.020) were identified as predictors of IMT for adults with DS and fasting insulin (p <0.001), age (p <0.001), gender (p <0.001), fruit and vegetable intake (p = 0.001), low-density lipoprotein cholesterol (p = 0.004), and smoking (p = 0.023) for controls. In conclusion, community residing adults with DS may be protected against atherosclerosis despite elevated total body fat and elevated cardiovascular disease risk factors. Predictors of IMT differed for patients with DS compared to controls, which indicates that patients with DS possess a unique model of atherogenesis.

Increased Coronary Heart Disease Risk Determined by High High-Density Lipoprotein Cholesterol and C-Reactive Protein: Modulation by Variation in the CETP Gene

Epidemiological evidence strongly favors the notion that the risk of cardiovascular disease (CVD) is inversely related to the plasma high-density lipoprotein (HDL) cholesterol concentration.1 Low HDL cholesterol is still predictive of high CVD risk in subjects with low LDL cholesterol,2 as well as during statin treatment.3 These observational data and other studies, which show that HDL particles contain a large number of antioxidative, antiinflammatory, and antiproliferative proteins, underlie the generally held view that HDL particles have atheroprotective properties.1–5 However, evidence is accumulating supporting the concept that high HDL cholesterol levels do not always predict reduced CVD risk. The Incremental Decrease in End Points through Aggressive Lipid Lowering (IDEAL) trial and the European Prospective Investigation into Cancer and Nutrition (EPIC)-Norfolk case-control study revealed that (recurrent) CVD risk is not decreased in subjects with the highest HDL cholesterol and the greatest mean HDL particle size.6 More recently, a high HDL cholesterol, high C-reactive protein (CRP) subgroup of individuals at increased risk for a first cardiovascular event was identified in the community-dwelling Prevention of Renal and Vascular End-Stage Disease (PREVEND) cohort using the “outcome event mapping approach,” a graphical exploratory data analysis tool that has been originally developed by Corsetti et al.7 Applying this analytic method to the Thrombogenic Factors and Recurrent Coronary Events (THROMBO) postinfarction cohort, the presence of a subgroup …

Insulin Resistance and Metabolic Syndrome in the Pediatric Population

The metabolic syndrome is a constellation of specific anthropometric, physiological, and biochemical abnormalities predisposing affected individuals to the development of diabetes and cardiovascular disease. The syndrome is well described in the adult literature. However, its description in the pediatric literature is more limited. Due in large part to the normal physiological changes that occur in children and adolescents with respect to growth and puberty, investigators have also struggled to establish a standard definition of the syndrome in the pediatric age group, hindering coordinated research efforts. However, whatever definition of the syndrome is used, the prevalence of the metabolic syndrome in the pediatric age group has increased worldwide. Insulin resistance is the principal metabolic abnormality that is common to the development of the metabolic syndrome in both children and adults. This review summarizes current research regarding the pathophysiology of insulin resistance and how this may contribute to specific abnormalities seen in children and adolescents with the metabolic syndrome. Specifically, insulin resistance in pediatric patients is correlated with cardiovascular risk factors such as elevated blood pressure, dyslipidemia, and type 2 diabetes mellitus, all of which are significant risk factors for adult disease. In addition, current treatment and prevention strategies, including lifestyle modifications, pharmacologic agents, and certain surgical therapies, are highlighted. The need for collaborative changes at the family, school, city, state, and national levels to address the growing prevalence of the metabolic syndrome in the pediatric age group is also reviewed.

Physical Fitness and Physical Activity at Age 13 Years as Predictors of Cardiovascular Disease Risk Factors at Ages 15, 25, 33, and 40 Years: Extended Follow-up of the Oslo Youth Study

Few studies have examined the association of childhood physical activity and physical fitness with cardiovascular disease risk factors in adulthood. Furthermore, interpretation of these findings is hampered by methodologic shortcomings. In a population-based cohort study, we explored the influence, if any, of childhood physical activity and physical fitness on later cardiovascular disease risk factors. Data were taken from the Oslo Youth Study, a prospective cohort study that began in 1979, when 1016 students (mean age: 13 years; range: 11-15 years) who were attending 6 schools were invited to participate in a health education intervention. Cardiovascular disease risk factor data were collected at baseline and again in 1981 (mean age: 15 years; range: 13-17 years), 1991 (mean age: 25; range: 23-27 years), 1999 (mean age: 33; range: 31-35 years), and 2006 (mean age: 40; range: 38-42 years). At baseline, physical fitness was inversely related to BMI, triceps skinfold thickness, and blood pressure (systolic and diastolic; N = 716). These associations were also present in prospective analyses at ages 15 (N = 472), 25 (N = 280; except for systolic blood pressure), and 33 years (N = 410, only BMI measured)-albeit with progressively diminishing magnitude-but were lost at 40 years (N = 294). There were fewer relationships with cardiovascular disease risk factors when physical activity was the exposure of interest. Controlling for educational attainment of both the parent and the study member had little impact on these associations. Although childhood physical fitness seems to reveal some inverse associations with obesity and blood pressure in early adulthood, these effects diminished markedly into middle age.

Season of birth affects short‐ and long‐term survival

Recent research findings have highlighted the importance of early life conditions as risk factors for adult diseases and therefore determinants of subsequent survival. Given that individuals born during different seasons in seasonal environments experience different early-developmental conditions, an analysis of the effects of the season of birth on survival is considered an effective approach in clarifying the influence of early life conditions on survival in later life. In the present study, we analyzed the long-term effects of early developmental conditions in a historical population in which both nutritional levels and the burden of infectious diseases showed a seasonal variation. Using a semi-computerized linkage process, we were able to match birth and death data for 4,646 individuals born between 1634 and 1870 in the village of Es Mercadal (Minorca Island, Spain). To determine ecological differences associated with the season of birth, we first evaluated the association between season of birth and early life survival. This analysis helped us to determine seasonal variations in early life conditions such as infectious burden and nutritional levels. The season of birth had a significant effect on long-term survival in the birth cohort 1800-1870: summer births had a lower risk of death after age 15. We explain these results in terms of lower susceptibility to degenerative diseases in adult years due to superior in utero nutrition for summer births. These findings support the fetal origin hypothesis which states that the early life environment plays a key role in shaping the subsequent phenotype and risk of adult disease.

What Can We Do to Control Childhood Obesity?

This issue of The Annals focuses on child hood obesity. Obesity now affects 18 per cent of U.S. children and adolescents (Ogden et al. 2006). Among children and adolescents, as for adults, African American and Mexican American populations are disproportionately affected. Although only 25 percent of adult obesity begins in childhood, childhood-onset obesity that persists into adulthood is associ ated with more severe adult obesity than obe sity that begins in adulthood (Freedman et al. 2001). Estimates from the Bogalusa Heart Study indicate that 50 percent of adults with a body mass index (BMI) greater than 40 (approximately one hundred pounds over weight) became obese before the age of eight (D. S. Freedman, unpublished data). Further more, the risk factors for adult disease are already present in childhood. For example, 60 percent of fiveto ten-year-old children have at least one additional risk factor for cardiovascu

To catch up or not to catch up: is this the question? Lessons from animal models

Low birth weight and accelerated postnatal catch-up growth during early life are independent risk factors for adult disease, including diabetes, obesity, and cardiovascular disease. As they are intimately linked, it is difficult to determine the independent contributions of birth weight and catch-up growth per se. This review focuses on evidence derived from animal models of disease, in which it is possible to dissect more clearly the independent roles of intrauterine growth retardation, low birth weight, and catch-up growth in mediating disease risk. Recent data from rats, mice and birds show that accelerated postnatal growth is a trigger for the development of adult disease and, ultimately, can affect longevity. Understanding the mechanisms and relative contribution of low birth weight and early postnatal catch-up growth to late onset of disease is critical to establish appropriate interventions to prevent or delay adult disease.

A Community-wide Pertussis Outbreak

Pertussis incidence has increased in the United States since 1980, punctuated by outbreaks that involve adults and adolescents. We investigated a community-wide outbreak and studied risk factors among adults to identify prevention and control opportunities. We analyzed surveillance data, interviewed patients, visited outbreak sites, and conducted a case-control study of risk factors for first-in-household adult infection during a Jackson County, Oregon, outbreak in 2003. In Jackson County, 135 pertussis cases were reported; the incidence was 71 per 100 000 population compared with 0 to 1 per 100 000 population from 1995 through 2001. Case investigations identified 2658 close contacts (19.7 per case); 1050 (40%) received antibiotic prophylaxis. Older children and adolescents (aged 10-17 years) and adults (aged > or =18 years) accounted for 67% of cases. Five infants were hospitalized (192 hospitalizations per 100 000 infants) compared with 18 in the remainder of the state (33 per 100 000 infants). Many cases occurred among epidemiologically linked clusters of varied composition, such as jail inmates and employees, methamphetamine users, low-income housing residents, school students and employees, and employees in certain work settings. Adult patients were more likely than controls to live with children aged 6 to 10 years (odds ratio, 6.4; 95% confidence interval, 1.8-23.4) and less likely to report a complete childhood vaccination history (odds ratio, 0.1; 95% confidence interval, 0.003-0.9). The predominance of adolescent and adult cases, appearance of new clusters despite aggressive control efforts, clustering of cases in hard-to-reach populations, and absence of modifiable risk factors for adult disease in this outbreak all suggest that universal booster vaccination of adolescents and adults might offer the only effective means to prevent such events in the future.

Endocrine regulation in asymmetric intrauterine fetal growth retardation

Objective. The ponderal index (PI) is a widely accepted measure of disproportionate growth or asymmetrical growth retardation by pediatricians worldwide. Identification of disproportionately grown small for gestational age (SGA) neonates by using the ponderal index as a measure of the nutritional status at birth, is important because they constitute a high-risk group among SGA neonates. Poor nutritional status of the mother could have a direct effect on the organs of the developing fetus and/or affect the endocrine milieu in the maternal feto-placental unit resulting in an increased incidence of intrauterine growth-retarded (IUGR)/SGA births. IUGR is a significant risk factor for adult disease. In this study, we have investigated the endocrine adaptation by the fetus to overcome the growth disadvantage caused due to poor nutritional status of the mother.Materials and methods. We examined the quantitative variations in hormonal and growth factor profiles in paired maternal and cord blood samples obtained from mothers and their neonates who were classified based on their growth status into SGA and appropriate for gestational age (AGA).Results. (1) A total of 24.7% neonates had a PI < 2, indicating a high incidence of asymmetric IUGR in the population studied. (2) Anthropometric parameters measured in the mothers indicate that the mothers giving birth to neonates with a PI < 2 had poor nutritional status, both prior to and during pregnancy. (3) We observed increased levels of placental lactogen and prolactin and decreased levels of insulin in the cord blood of neonates with PI < 2, while lower levels of insulin-like growth factor 1 (IGF-1) and higher levels of epidermal growth factor (EGF) were observed in their mothers.Conclusion. Poor maternal nutritional status results in fetal adaptation to a growth restricted environment via the modulation of the pituitary–thyroid axis thereby altering the endocrine milieu, thus affecting fetal growth.

Relationship between adolescent fitness and fatness and cardiovascular disease risk factors in adulthood: The Aerobics Center Longitudinal Study (ACLS)

To examine the relationship between cardiorespiratory fitness and body fatness during adolescence and cardiovascular disease (CVD) risk factors in adulthood. The sample was 48 participants from the Aerobics Center Longitudinal Study (ACLS) who had one clinical visit during adolescence (mean age = 15.8 years) and a follow-up visit during adulthood (mean age = 26.6 years). Values for treadmill time (TM), body fatness (body mass index [BMI], percent body fat [%BF], and waist circumference [WC]), traditional CVD risk factors (blood pressure [BP], fasting total cholesterol [TC], high-density lipoprotein cholesterol [HDL-C], triglycerides [TG], and glucose), and a composite metabolic syndrome risk factor score were adjusted for age and sex. The relationships between adolescent TM and body fatness variables and adult CVD risk factors were examined by partial correlations, controlling for length of follow-up (mean = 11 years). The correlation between changes in TM and body fatness (DeltaTM and Deltabody fatness, respectively) and changes in CVD risk factors between adolescence and adulthood (DeltaCVD risk factors) were also examined. Adolescent cardiorespiratory fitness and body fatness variables also were separated into 2 categories based on the median split: low (below median) and high (above median). TM and body fatness variables showed moderate stability between adolescence and adulthood ( r = 0.44-0.78). Adolescent TM and DeltaTM showed moderate correlations with adult body fatness indicators (BMI, WC, and %BF, r = -0.34 to -0.47) and Deltabody fatness ( r = -0.24 to -0.46), respectively. Adolescent TM was not significantly related to traditional CVD risk factors in adulthood. Adolescent WC was significantly related to adult BP ( r = 0.33 to 0.45), and body fatness variables during adolescence were significantly related to adult TM ( r = -0.32 to -0.44). The DeltaWC was significantly related to DeltaTM ( r = -0.46) and DeltaHDL-C ( r = -0.51), and DeltaBMI was significantly related to DeltaBP ( r = 0.45) and DeltaHDL-C ( r = -0.34). Subjects with a high TM during adolescence showed lower levels of body fatness as adults, and those with high levels of WC during adolescence showed higher BP during adulthood. The results indicate a significant relationship between adolescent cardiorespiratory fitness and adult body fatness and a lack of an association between adolescent cardiorespiratory fitness and adult cholesterol, BP, and glucose levels. Adolescent body fatness is moderately related to selected adult CVD risk factors.

Effect of age on carotid arterial intima-media thickness in childhood.

To investigate relationships between carotid arterial intima-media thickness (IMT) and age in childhood, we performed high-resolution carotid arterial ultrasonography in 60 healthy children (27 boys, 33 girls; age range, 5-14 years) determined by screening to have no dyslipidemia or hypertension. No plaque formation was found, and irregularity of IMT (root mean square roughness of IMT) did not correlate with age. Mean IMT increased in a linear manner with age [IMT in millimeters = (0.009 x age in years) + 0.35] ( r = 0.39, P = 0.002). This correlation remained significant after adjustment for gender, parental smoking, systolic and diastolic blood pressure, body mass index, and serum concentrations of low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglycerides. None of these known cardiovascular disease risk factors in adults had a significant relationship with age-adjusted IMT in children. While circumferential wall stress and diastolic blood pressure were not correlated with age, mean IMT and lumen diameter showed significant positive relationships with circulating blood volume, which was calculated as the function of height and weight. These data suggested that age-dependent physiologic thickening of arterial walls begins in childhood.

Maternal-fetal interactions and birth order influence insulin variable number of tandem repeats allele class associations with head size at birth and childhood weight gain.

Polymorphism of the insulin gene (INS) variable number of tandem repeats (VNTR; class I or class III alleles) locus has been associated with adult diseases and with birth size. Therefore, this variant is a potential contributory factor to the reported fetal origins of adult disease. In the population-based Avon Longitudinal Study of Pregnancy and Childhood birth cohort, we have confirmed in the present study the association between the INS VNTR III/III genotype and larger head circumference at birth (odds ratio [OR] 1.92, 95% CI 1.23-3.07; P = 0.004) and identified an association with higher cord blood IGF-II levels (P = 0.05 to 0.0001). The genotype association with head circumference was influenced by maternal parity (birth order): the III/III OR for larger head circumference was stronger in second and subsequent pregnancies (OR 5.0, 95% CI 2.2-11.5; P = 0.00003) than in first pregnancies (1.2, 0.6-2.2; P = 0.8; interaction with birth order, P = 0.02). During childhood, the III/III genotype remained associated with larger head circumference (P = 0.004) and was also associated with greater BMI (P = 0.03), waist circumference (P = 0.03), and higher fasting insulin levels in girls (P = 0.02). In addition, there were interactions between INS VNTR genotype and early postnatal weight gain in determining childhood BMI (P = 0.001 for interaction), weight (P = 0.005), and waist circumference (P = 0.0005), such that in the approximately 25% of children (n = 286) with rapid early postnatal weight gain, class III genotype-negative children among this group gained weight more rapidly. Our results indicate that complex prenatal and postnatal gene-maternal/fetal interactions influence size at birth and childhood risk factors for adult disease.

Achievement Orientation and Physical Activity in Elementary Physical Education Classes

Introduction: The level of physical activity is important to the health of children and has been related to various adult disease risk factors (Baranowski, Thompson, DuRant, Baranowski & Puhl, 1993). Many researchers examined the magnitude of prediction for physical activity according to childrens' goal orientation. (e.g. Biddle, Soos & Chatzisarantis, 1999; Lintunen, Valkonen, Leskinen & Biddle, 1999). The purpose of the present study was to compare students' physical activity according to their achievement orientation during elementary physical education classes. Method: In this research 108 children participated 8–11 years old with equal number of boys and girls in each group. For the evaluation of the physical activity an accelerometer (Computer Science Actigraph) mounted on students' right hip during the physical education classes. Students also completed an achievement orientation questionnaire and they were classified into four groups according to their scores: low – high task orientation and low – high ego orientation. Results: Analysis of variance revealed a significant (F = 3,61, p < .05) main effect for the group. High ego – high task orientation group was significantly less active than the other three groups. Descreptives of the physical activity as measured by the CSA instrument are shown in the table below:Table: No Caption AvailableDiscussion: It seems that children who compete other students and themselves were less active through physical education classes. This might be due to their disappointment deriving from the lack of opportunities to compete or lack of personal goal setting. The content of physical education classes were mostly oriented toward teaching new skills and less evaluation of performance.

Relationship of childhood obesity to coronary heart disease risk factors in adulthood: the Bogalusa Heart Study.

Childhood obesity is related to adult levels of lipids, lipoproteins, blood pressure, and insulin and to morbidity from coronary heart disease (CHD). However, the importance of the age at which obesity develops in these associations remains uncertain. We assessed the longitudinal relationship of childhood body mass index (BMI, kg/m(2)) to adult levels of lipids, insulin, and blood pressure among 2617 participants. All participants were initially examined at ages 2 to 17 years and were reexamined at ages 18 to 37 years; the mean follow-up was 17 years. Of the overweight children (BMI >/=95th percentile), 77% remained obese (>/=30 kg/m(2)) as adults. Childhood overweight was related to adverse risk factor levels among adults, but associations were weak (r ~ 0.1-0.3) and were attributable to the strong persistence of weight status between childhood and adulthood. Although obese adults had adverse levels of lipids, insulin, and blood pressure, levels of these risk factors did not vary with childhood weight status or with the age (</=8 years, 12-17 years, or >/=18 years) of obesity onset. Additional data are needed to assess the independent relationship of childhood weight status to CHD morbidity. Because normal-weight children who become obese adults have adverse risk factor levels and probably will be at increased risk for adult morbidity, our results emphasize the need for both primary and secondary prevention.

Glucose, insulin and lipid metabolism in rural Gambians exposed to early malnutrition.

There is now substantial evidence to suggest that susceptibility to certain non-communicable diseases may be increased by early undernutrition. In rural Gambia, an annual hungry season reduces birth weight by 200-300 g and increases the prevalence of low birth weight (< 2500 g) from 11% to 24%. The aim of this study was to investigate whether fetal nutritional stress (using season of birth as a proxy measure for prenatal growth retardation) or early childhood malnutrition (using historical anthropometric records) had a residual influence on risk factors for cardiovascular disease in a cohort of rural Gambian adults. Two hundred and nineteen adults (mean age = 35.8 years; mean body mass index = 21.3 kg/m2; women = 181) for whom month of birth and infant anthropometric records were available participated in this study. Risk factors for cardiovascular disease were measured. No differences were found between season of birth groups (hungry vs. harvest) and fasting measures of glucose, insulin, lipids, fibrinogen or cortisol, or against 30 and 120 min glucose and insulin levels following an oral glucose tolerance test, or blood pressure. Similarly, these risk factors for adult disease were not related to the subjects' weight-for-age as children. Moderate-to-severe fetal and childhood malnutrition in rural Gambia caused no detectable impairment of the glucose/insulin axis, or of other cardiovascular disease risk factors in adults remaining lean and fit on a low-fat diet.