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Lee SH, Lyu J. Social Mobility and Cognitive Impairment Among Korean Older Adults: Does Gender Matter? J Appl Gerontol 2024; 43:446-453. [PMID: 38016111 DOI: 10.1177/07334648231210672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2023] Open
Abstract
The purpose of this study is to investigate the association between social mobility and cognitive impairment among older adults in Korea. The study sample is drawn from nationally representative data, which comes from the 2016 Korean Longitudinal Study of Ageing (KLoSA). The final sample consists of 4264 KLoSA respondents aged 65 or older. Gender-specific logistic regression models are used to examine the association between social mobility and cognitive impairment. The results show that, when compared to the reference group (stable low social mobility), women in the downward and the stable high social mobility groups were less likely to have cognitive impairment. In contrast, upward social mobility was a protective factor for cognitive impairment only among men. Gender-specific interventions may be needed to enhance cognitive health among older Koreans. Further research is needed to examine the causal relations between social mobility and cognitive health between the genders.
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Affiliation(s)
- Seungah H Lee
- Independent Research Consultant, Franklin Lakes, NJ, USA
| | - Jiyoung Lyu
- Institute of Aging, Hallym University, Chuncheon, Korea
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2
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Espinosa Dice AL, Lawn RB, Ratanatharathorn A, Roberts AL, Denckla CA, Kim AH, de la Rosa PA, Zhu Y, VanderWeele TJ, Koenen KC. Childhood maltreatment and health in the UK Biobank: triangulation of outcome-wide and polygenic risk score analyses. BMC Med 2024; 22:135. [PMID: 38523269 PMCID: PMC10962116 DOI: 10.1186/s12916-024-03360-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 03/15/2024] [Indexed: 03/26/2024] Open
Abstract
BACKGROUND Childhood maltreatment is common globally and impacts morbidity, mortality, and well-being. Our understanding of its impact is constrained by key substantive and methodological limitations of extant research, including understudied physical health outcomes and bias due to unmeasured confounding. We address these limitations through a large-scale outcome-wide triangulation study. METHODS We performed two outcome-wide analyses (OWAs) in the UK Biobank. First, we examined the relationship between self-reported maltreatment exposure (number of maltreatment types, via Childhood Trauma Screener) and 414 outcomes in a sub-sample of 157,316 individuals using generalized linear models ("observational OWA"). Outcomes covered a broad range of health themes including health behaviors, cardiovascular disease, digestive health, socioeconomic status, and pain. Second, we examined the relationship between a polygenic risk score for maltreatment and 298 outcomes in a non-overlapping sample of 243,006 individuals ("genetic OWA"). We triangulated results across OWAs based on differing sources of bias. RESULTS Overall, 23.8% of the analytic sample for the observational OWA reported at least one maltreatment type. Of 298 outcomes examined in both OWAs, 25% were significant in both OWAs and concordant in the direction of association. Most of these were considered robust in the observational OWA according to sensitivity analyses and included outcomes such as marital separation (OR from observational OWA, ORo = 1.25 (95% CI: 1.21, 1.29); OR from genetic OWA, ORg = 1.06 (1.03, 1.08)), major diet changes due to illness (ORo = 1.27 (1.24, 1.29); ORg = 1.01 (1.00, 1.03)), certain intestinal diseases (ORo = 1.14 (1.10, 1.18); ORg = 1.03 (1.01, 1.06)), hearing difficulty with background noise (ORo = 1.11 (1.11, 1.12); ORg = 1.01 (1.00, 1.01)), knee arthrosis (ORo = 1.13 (1.09, 1.18); ORg = 1.03 (1.01, 1.05)), frequent sleeplessness (ORo = 1.21 (1.20, 1.23); ORg = 1.02 (1.01, 1.03)), and low household income (ORo = 1.28 (1.26, 1.31); ORg = 1.02 (1.01, 1.03)). Approximately 62% of results were significant in the observational OWA but not the genetic OWA, including numerous cardiovascular outcomes. Only 6 outcomes were significant in the genetic OWA and null in the observational OWA; these included diastolic blood pressure and glaucoma. No outcomes were statistically significant in opposite directions in the two analyses, and 11% were not significant in either OWA. CONCLUSIONS Our findings underscore the far-reaching negative effects of childhood maltreatment in later life and the utility of an outcome-wide triangulation design with sensitivity analyses for improving causal inference.
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Affiliation(s)
- Ana Lucia Espinosa Dice
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA.
| | - Rebecca B Lawn
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Andrew Ratanatharathorn
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York City, NY, USA
| | - Andrea L Roberts
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Christy A Denckla
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Ariel H Kim
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Molecular and Cellular Biology, Harvard University, Cambridge, MA, USA
| | - Pedro A de la Rosa
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Institute for Culture and Society, University of Navarra, Pamplona, Spain
| | - Yiwen Zhu
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Tyler J VanderWeele
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Karestan C Koenen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Psychiatric Neurodevelopmental Genetics Unit, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
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Poursalehi D, Bahrami G, Mirzaei S, Asadi A, Akhlaghi M, Saneei P. Association between alternative healthy eating index (AHEI) with metabolic health status in adolescents with overweight and obesity. BMC Public Health 2024; 24:42. [PMID: 38166997 PMCID: PMC10763351 DOI: 10.1186/s12889-023-17558-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 12/21/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND There has been lack of evidence on the association between healthy dietary patterns and metabolic health status of adolescents. The present study aimed to evaluate the association between alternative healthy eating index (AHEI) and metabolic health status among a relatively representative sample of Iranian adolescents with overweight/obesity. METHODS Adolescents with extra body weight (n = 203, aged 12-18 y), were selected for this cross-sectional study by a multistage cluster random-sampling method. Habitual dietary intakes and diet quality of individuals were assessed using validated food frequency questionnaire and AHEI-2010, respectively. Data on other covariates were also gathered by pre-tested questionnaires. To determine fasting glucose, insulin and lipid profiles, fasting blood samples were collected. Participants were categorized as having metabolically healthy overweight/obesity (MHO) or metabolically unhealthy overweight/obesity (MUO) phenotypes, based on two approaches (International Diabetes Federation (IDF) and combination of IDF with Homeostasis Model Assessment Insulin Resistance (HOMA-IR)). RESULTS The overall prevalence of MUO was 38.9% (based on IDF criteria) and 33.0% (based on IDF/HOMA-IR criteria). After considering all potential confounders, participants in highest tertiles of AHEI-2010 had lower odds of MUO profile according to both IDF (OR = 0.05; 95% CI: 0.01-0.15) and IDF/HOMA-IR (OR = 0.05; 95% CI: 0.02-0.19) definitions. This association was stronger in adolescents with overweight compared with obese ones and also among girls than boys. Moreover, each unit increase in AHEI-2010 score was associated with lower risk of MUO based on both criteria. CONCLUSIONS Higher adherence to AHEI-2010 was inversely associated with odds of MUO in Iranian adolescents with overweight/obesity.
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Affiliation(s)
- Donya Poursalehi
- Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Community Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, PO Box 81745-151, Isfahan, Iran
| | - Ghazaleh Bahrami
- Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Community Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, PO Box 81745-151, Isfahan, Iran
| | - Saeideh Mirzaei
- Department of Community Nutrition, School of Nutrition and Food Science, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Asadi
- Department of Exercise Physiology, School of Physical Education and Sport Sciences, University of Tehran, Tehran, Iran
| | - Masoumeh Akhlaghi
- Department of Community Nutrition, School of Nutrition and Food Science, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Parvane Saneei
- Department of Community Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, PO Box 81745-151, Isfahan, Iran.
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Cockerham WC. Health Lifestyle Theory in a Changing Society: The Rise of Infectious Diseases and Digitalization. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2023; 64:437-451. [PMID: 36912383 DOI: 10.1177/00221465231155609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Social change produces alterations in society that necessitate changes in sociological theories. Two significant changes affecting health lifestyle theory are the behaviors associated with the COVID-19 pandemic and the digitalization of society. The health-protective practices emerging from the ongoing pandemic and the recent parade of other newly emerging infectious diseases need to be included in the theory's framework. Moreover, the extensive digitalization of today's society leads to the addition of connectivities (electronic networks) as a structural variable. Connectivities serve as a computational authority influencing health lifestyle practices through health apps and other digital resources in contrast to collectivities (human social networks) as a normative authority. The recent literature supporting these features in an updated and expanded model of health lifestyle theory is discussed.
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Affiliation(s)
- William C Cockerham
- University of Alabama at Birmingham, Birmingham, AL, USA
- College of William & Mary, Williamsburg, VA, USA
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Cockerham WC, Bauldry S, Sims M. Obesity-Related Health Lifestyles of Late-Middle Age Black Americans: The Jackson Heart Study. Am J Prev Med 2022; 63:S47-S55. [PMID: 35725140 PMCID: PMC9219285 DOI: 10.1016/j.amepre.2022.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 02/04/2022] [Accepted: 02/07/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION This article examines the obesity-related health lifestyle practices of a late-middle age cohort of socioeconomically diverse Black Americans. Black people have the highest prevalence of obesity of any racial group in the U.S. Consequently, the obesity-related health lifestyles of this population is an important topic of investigation, including those in late-middle age for whom there is little data. METHODS This study employs latent class analysis (LCA) and multinomial logit models to investigate dietary habits, levels of exercise, alcohol use, and smoking. The analysis sample is from the first examination of the Jackson Heart Study (2000‒2004) analyzed in 2021 using LCA. The sample consists of 739 Black men and 1,351 women between the ages of 50 and 64 years. RESULTS Three classes of lifestyles were found for both genders: healthy diet, unhealthy diet, and unhealthy smokers. For women only, a most healthy lifestyle was added. Major findings are the low levels of physical activity, a clear socioeconomic pattern in healthy lifestyles among Black men and women, and the association of diagnoses of diabetes and cardiovascular disease with healthier lifestyle practices among Black men but not among women. CONCLUSIONS Obesity-related health lifestyles among late-middle aged Black Americans generally do not converge toward a healthier norm with impending old age. An exception is men who have been diagnosed as having diabetes or heart disease. Otherwise, healthy and unhealthy lifestyle practices remain aligned by social class during this period of the life course.
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Affiliation(s)
- William C Cockerham
- Department of Sociology, College of Arts and Sciences, The University of Alabama at Birmingham, Birmingham, Alabama; Division of Preventive Medicine, Heersink School of Medicine, The University of Alabama at Birmingham, Birmingham, Alabama; Department of Sociology, College of William & Mary, Williamsburg, Virginia.
| | - Shawn Bauldry
- Department of Sociology, College of Liberal Arts, Purdue University, West Lafayette, Indiana
| | - Mario Sims
- Department of Medicine, The University of Mississippi Medical Center, Jackson, Mississippi
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McClain AC, Cory H, Mattei J. Childhood food insufficiency and adulthood cardiometabolic health conditions among a population-based sample of older adults in Puerto Rico. SSM Popul Health 2022; 17:101066. [PMID: 35313605 PMCID: PMC8933531 DOI: 10.1016/j.ssmph.2022.101066] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 03/02/2022] [Accepted: 03/03/2022] [Indexed: 02/08/2023] Open
Abstract
Childhood food insufficiency negatively influences physical and psychosocial health in children, but less is known about long-term health implications. This study aimed to elucidate the association of childhood food insufficiency with older adulthood cardiometabolic conditions. We conducted cross-sectional analyses using data from the Puerto Rican Elderly: Health Conditions Project (n = 2712), a population-based sample of elderly adults (>60 y) living in Puerto Rico. Childhood food insufficiency was ascertained with a proxy question on childhood economic hardships that prevented eating. Participants self-reported hypertension, diabetes, and cardiovascular disease (CVD; including heart attack, heart disease, or stroke). Obesity was assessed as body mass index using measured height and weight. Multivariable-adjusted, sex-stratified, complex survey logistic regression models tested associations of childhood food insufficiency with each condition, number of cardiometabolic conditions (0-6), and age of onset. Nearly a third (29.4%) of the sample reported childhood food insufficiency; 68.7% reported hypertension, 29.6% reported type 2 diabetes, 34.2% reported CVD, 29.9% were categorized with obesity, and 55.4% had two or more cardiometabolic conditions. In men, but not women, childhood food insufficiency was associated with higher odds of hypertension (Odds Ratio (OR) (95% Confidence Intervals (CI)): 1.7 (1.1, 2.7)), CVD (1.7 (1.1, 2.6)), and having two (1.9 (1.0, 3.4) or three to four (2.3 (1.2, 4.4)) cardiometabolic conditions. Childhood food insufficiency was marginally associated with higher odds of early age of onset of CVD among men (2.2 (1.0, 4.7)). Childhood food insufficiency may increase the likelihood of having cardiometabolic conditions in Puerto Rican older men. Programs that enable access to sufficient, healthy food in childhood may help prevent eventual cardiovascular-related diseases.
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Affiliation(s)
- Amanda C. McClain
- School of Exercise and Nutritional Sciences, San Diego State University, 5500 Campanile Drive, San Diego, CA, 92182, USA,Corresponding author.
| | - Hannah Cory
- Department of Nutrition, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA
| | - Josiemer Mattei
- Department of Nutrition, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA
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Whitaker RC, Dearth-Wesley T, Herman AN, Block AE, Holderness MH, Waring NA, Oakes JM. The interaction of adverse childhood experiences and gender as risk factors for depression and anxiety disorders in US adults: a cross-sectional study. BMC Public Health 2021; 21:2078. [PMID: 34772386 PMCID: PMC8590371 DOI: 10.1186/s12889-021-12058-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 10/18/2021] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Exposure to adverse childhood experiences (ACEs) and being female are distinct risk factors for having a major depressive episode (MDE) or an anxiety disorder (AD) in adulthood, but it is unclear whether these two risk factors are synergistic. The purpose of this study was to determine whether exposure to ACEs and being female are more than additive (synergistic) in their association with MDE and AD in US adults. METHODS We pooled cross-sectional survey data in the Midlife in the United States study from two nationally-representative cohorts of English-speaking US adults. Data from the first cohort were collected in 2004-2006 and from the second in 2011-2014. Data from both cohorts included the 12-month prevalence of MDE and AD (generalized anxiety disorder or panic disorder) assessed with the Composite International Diagnostic Interview Short Form, gender (here termed female and male), and the count of five categories of exposure to ACEs: physical, sexual, or emotional abuse; household alcohol or substance abuse; and parental separation or divorce. RESULTS Of the 5834 survey respondents, 4344 (74.5%) with complete data on ACEs were included in the analysis. Mean (SD) age was 54.1 (13.8) years and 53.9% were female. The prevalences of MDE, AD, and exposure to 3-5 categories of ACEs were 13.7, 10.0, and 12.5%, respectively. After adjusting for covariates (age, race, and current and childhood socioeconomic disadvantage), for those with both risk factors (female and 3-5 ACEs) the prevalence of MDE was 26.9%. This was 10.2% (95% CI: 1.8, 18.5%) higher than the expected prevalence based on the additive associations of the two risk factors. The adjusted prevalence of AD among females with 3-5 ACEs was 21.9%, which was 11.4% (95% CI: 4.0, 18.9%) higher than the expected prevalence. CONCLUSIONS For both MDE and AD, there was synergy between the two risk factors of exposure to ACEs and being female. Identification and treatment of MDE and AD may benefit from understanding the mechanisms involved in the synergistic interaction of gender with ACEs.
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Affiliation(s)
- Robert C Whitaker
- Columbia-Bassett Program, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA. .,Columbia-Bassett Program, Bassett Medical Center, Cooperstown, NY, USA. .,Bassett Research Institute, Bassett Medical Center, Cooperstown, NY, USA. .,Department of Pediatrics, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA.
| | - Tracy Dearth-Wesley
- Columbia-Bassett Program, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA.,Columbia-Bassett Program, Bassett Medical Center, Cooperstown, NY, USA.,Bassett Research Institute, Bassett Medical Center, Cooperstown, NY, USA
| | - Allison N Herman
- Columbia-Bassett Program, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA.,Columbia-Bassett Program, Bassett Medical Center, Cooperstown, NY, USA.,Bassett Research Institute, Bassett Medical Center, Cooperstown, NY, USA
| | - Amy E Block
- Columbia-Bassett Program, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA.,Columbia-Bassett Program, Bassett Medical Center, Cooperstown, NY, USA.,Bassett Research Institute, Bassett Medical Center, Cooperstown, NY, USA
| | - Mary Howard Holderness
- Columbia-Bassett Program, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA.,Columbia-Bassett Program, Bassett Medical Center, Cooperstown, NY, USA.,Bassett Research Institute, Bassett Medical Center, Cooperstown, NY, USA
| | - Nicholas A Waring
- Columbia-Bassett Program, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA.,Columbia-Bassett Program, Bassett Medical Center, Cooperstown, NY, USA.,Bassett Research Institute, Bassett Medical Center, Cooperstown, NY, USA
| | - J Michael Oakes
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
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Mesler RM, Simpson B, Bates Z, Hinrichs Y. Unhealthy food choices in adulthood: The role of childhood financial adversity, situational scarcity, and self-control. Food Qual Prefer 2021. [DOI: 10.1016/j.foodqual.2021.104433] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Crenshaw EG, Fernández-Rhodes L, Martin CL, Gordon-Larsen P, Haan MN, Aiello AE. Intergenerational Educational Attainment and Cardiometabolic Health in Latino Individuals Living in the United States. Obesity (Silver Spring) 2021; 29:1178-1185. [PMID: 34096684 PMCID: PMC8549077 DOI: 10.1002/oby.23156] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 02/14/2021] [Accepted: 02/16/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVE This study aimed to estimate the association between cycles of poverty, measured by intergenerational educational attainment (IEA), and the burden of obesity and metabolic dysfunction among Hispanic/Latino individuals in the United States. METHODS This is a cross-sectional study utilizing data from 392 adults linked to 286 biologic parents from the Niños Lifestyle and Diabetes Study and the Sacramento Area Latino Study on Aging. The educational attainment of parents and offspring was dichotomized in order to categorize IEA. Outcomes included obesity and metabolic syndrome (MetS). Model-based standardization with population weights was used to compare obesity and MetS across generations, and Poisson regression was used to estimate prevalence ratios by IEA. RESULTS A higher prevalence of obesity and MetS was observed in offspring (54% and 69%, respectively) compared with their parents (48% and 42%, respectively). Compared with stable-low IEA, any category with high offspring education was associated with lower obesity and MetS prevalence. The upwardly mobile group saw the greatest benefit; they were 38% (95% CI: 10%-57%) and 46% (95% CI: 21%-63%) less likely to have obesity or MetS. CONCLUSIONS IEA strongly patterns cardiometabolic health among Hispanic/Latino individuals living in the United States, suggesting that promotion of higher education is associated with reductions in obesity and MetS, potentially benefitting future generations of this population.
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Affiliation(s)
- Emma G. Crenshaw
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
| | - Lindsay Fernández-Rhodes
- Carolina Population Center, University of North Carolina, Chapel Hill, NC
- Department of Biobehavioral Health, College of Health and Human Development, Pennsylvania State University, University Park, PA
| | - Chantel L. Martin
- Carolina Population Center, University of North Carolina, Chapel Hill, NC
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
| | - Penny Gordon-Larsen
- Carolina Population Center, University of North Carolina, Chapel Hill, NC
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill
| | - Mary N. Haan
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA
| | - Allison E. Aiello
- Carolina Population Center, University of North Carolina, Chapel Hill, NC
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
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Lemes V, Gaya AR, Sadarangani KP, Aguilar-Farias N, Rodriguez-Rodriguez F, Martins CMDL, Fochesatto C, Cristi-Montero C. Physical Fitness Plays a Crucial Mediator Role in Relationships Among Personal, Social, and Lifestyle Factors With Adolescents' Cognitive Performance in a Structural Equation Model. The Cogni-Action Project. Front Pediatr 2021; 9:656916. [PMID: 34195161 PMCID: PMC8236613 DOI: 10.3389/fped.2021.656916] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 05/19/2021] [Indexed: 12/13/2022] Open
Abstract
Background: The beneficial relationship between physical fitness and cognitive performance is affected and modulated by a wide diversity of factors that seem to be more sensitive during the development stage, particularly during early adolescence. This study aimed to examine the role of physical fitness considering the multivariate association between age, health-related quality of life (HRQOL), school vulnerability index (SVI), body mass index z-score (BMIz), physical activity, and sleep problems with the cognitive performance in boys and girls. Method: Participants were 1,196 adolescents aged 10-14 years (50.7% of boys) from Chile. Three physical fitness components and eight cognitive tasks were measured. BMIz was determined using growth references by age and sex, whereas questionaries were used to assess sleep problems, physical activity, and HRQOL. SVI was established according to the score given by the Chilean Government to educational establishments. We performed a structural equation model (SEM) to test multivariate associations among study' variables by sex. Results: Fitness was positively associated with boys' and girls' cognitive performance (β = 0.23 and β = 0.17; p = 0.001, respectively). Moreover, fitness presented a significant mediator role in the relationships between BMIz, SVI, and physical activity with cognitive performance (indirect effect). Additionally, SVI showed a negative association both direct and indirect effect in all three fitness components and all cognitive tasks, being this relationship stronger in girls than in boys. Conclusion: Our findings suggest that physical fitness and all its components play a crucial mediator role in the associations between several factors associated with adolescents' cognitive performance. Thereby, educational and health strategies should prioritise improving physical fitness through physical activity. They also should address other factors such as school vulnerability, obesity, and the early gender gap in a comprehensive approach boosting cognitive performance among early adolescents. Trial registration: Research Registry (ID: researchregistry5791).
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Affiliation(s)
- Vanilson Lemes
- Projeto Esporte Brasil – PROESP-Br, Escola de Educação Física, Fisioterapia e Dança, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Secretaria de Estado da Educação de Santa Catarina – SED-SC, EEB Gracinda Augusta Machado, Imbituba, Brazil
| | - Anelise R. Gaya
- Projeto Esporte Brasil – PROESP-Br, Escola de Educação Física, Fisioterapia e Dança, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Kabir P. Sadarangani
- Universidad Autónoma de Chile, Providencia, Chile
- Escuela de Kinesiología, Facultad de Salud y Odontología, Universidad Diego Portales, Santiago, Chile
| | - Nicolas Aguilar-Farias
- Department of Physical Education, Sports, and Recreation, Universidad de La Frontera, Temuco, Chile
- UFRO Activate Research Group, Universidad de La Frontera, Temuco, Chile
| | | | - Clarice Maria de Lucena Martins
- Research Centre in Physical Activity, Health, and Leisure - CIAFEL, Porto University, Porto, Portugal
- Federal University of Paraíba, João Pessoa, Brazil
| | - Camila Fochesatto
- Projeto Esporte Brasil – PROESP-Br, Escola de Educação Física, Fisioterapia e Dança, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Carlos Cristi-Montero
- IRyS Group, Physical Education School, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile
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Lee C, Harari L, Park S. Early-Life Adversities and Recalcitrant Smoking in Midlife: An Examination of Gender and Life-Course Pathways. Ann Behav Med 2020; 54:867-879. [PMID: 32329785 DOI: 10.1093/abm/kaaa023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Little is known about life-course factors that explain why some individuals continue smoking despite having smoking-related diseases. PURPOSE We examined (a) the extent to which early-life adversities are associated with the risk of recalcitrant smoking, (b) psychosocial factors that mediate the association, and (c) gender differences in the associations. METHODS Data were from 4,932 respondents (53% women) who participated in the first and follow-up waves of the Midlife Development in the U.S. National Survey. Early-life adversities include low socioeconomic status (SES), abuse, and family instability. Potential mediators include education, financial strain, purpose in life, mood disorder, family problems/support, and marital status. We used sequential logistic regression models to estimate the effect of early-life adversities on the risk of each of the three stages on the path to recalcitrant smoking (ever-smoking, smoking-related illness, and recalcitrant smoking). RESULTS For women, low SES (odds ratio [OR] = 1.29; 1.06-1.55) and family instability (OR = 1.73; 1.14-2.62) are associated with an elevated risk of recalcitrant smoking. Education significantly reduces the effect of childhood SES, yet the effect of family instability remains significant even after accounting for life-course mediators. For men, the effect of low SES on recalcitrant smoking is robust (OR = 1.48; 1.10-2.00) even after controlling for potential mediators. There are noteworthy life-course factors that independently affect recalcitrant smoking: for both genders, not living with a partner; for women, education; and for men, family problems. CONCLUSIONS The findings can help shape intervention programs that address the underlying factors of recalcitrant smoking.
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Affiliation(s)
- Chioun Lee
- Department of Sociology, University of California-Riverside, Riverside, CA, USA
| | - Lexi Harari
- Department of Sociology, University of California-Riverside, Riverside, CA, USA
| | - Soojin Park
- Graduate School of Education, University of California-Riverside, Riverside, CA, USA
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Williams AD, Shenassa ED. Sex-Specific Associations Between Area-Level Poverty and Cardiometabolic Dysfunction Among US Adolescents. Public Health Rep 2019; 135:47-55. [PMID: 31725345 DOI: 10.1177/0033354919884303] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE Cardiometabolic disease is the leading cause of mortality in the United States. Cardiometabolic function during adolescence predicts future cardiometabolic disease, yet few studies have examined early determinants of cardiometabolic function. Informed by evidence of sex differences in the prevalence and severity of cardiometabolic disorders and evidence of sexual dimorphism in the stress response, we examined sex differences in the association between living in poverty and cardiometabolic function during adolescence, a precursor of later cardiometabolic disorders. METHODS We linked data from 10 415 adolescents aged 12-19 in the National Health and Nutrition Examination Survey (1999-2012) with US Census-tract data on area-level poverty (percentage of the population living in poverty, grouped into quartiles). We parameterized cardiometabolic dysfunction by summing the z scores of 6 cardiometabolic biomarkers, grouped into quintiles. Hierarchical ordinal models estimated associations. RESULTS Compared with residents in low-poverty areas, residents in high-poverty areas had elevated odds of cardiometabolic dysfunction (highest quartile of poverty odds ratio [OR] = 1.27; 95% confidence interval [CI], 1.08-1.50). This association was more pronounced among boys than girls (highest quartile of poverty for boys: OR = 1.36; 95% CI, 1.10-1.70; highest quartile of poverty for girls: OR = 1.17; 95% CI, 0.94-1.47). CONCLUSION Our study supports the existence of sex-specific associations. These results highlight the potential for community-based programs, such as housing assistance, to improve population health.
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Affiliation(s)
- Andrew D Williams
- Department of Family Science, Maternal and Child Health Program, University of Maryland College Park, College Park, MD, USA
| | - Edmond D Shenassa
- Department of Family Science, Maternal and Child Health Program, University of Maryland College Park, College Park, MD, USA.,Department of Epidemiology and Biostatistics, University of Maryland College Park, College Park, MD, USA.,Department of Epidemiology and Biostatistics, School of Public Health, Brown University, Providence, RI, USA.,Department of Epidemiology and Biostatistics, School of Medicine, University of Maryland Baltimore, Baltimore, MD, USA
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Abstract
A growing body of work identifies distinct health lifestyles among children, adolescents, and young adults and documents important social correlates. This study contributes to that line of research by identifying the health lifestyles of U.S. adults entering late middle age, assessing structural predictors of membership in different health lifestyles in this understudied age-group, and examining net associations between health lifestyles, chronic conditions, and physical health. The data come from the National Longitudinal Survey of Youth 1979 50+ Health Module. The analysis is based on respondents who answered the 50+ Health Module in 2008, 2010, 2012, or 2014 (N = 7,234). The results confirm similar relationships between health lifestyles and structural factors like class, gender, and race that prior studies observe and also reveal a unique pattern of associations between health lifestyle and health status because of diagnosed conditions that impact health behaviors in adulthood.
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Affiliation(s)
- William C Cockerham
- University of Alabama at Birmingham, AL and College of William & Mary, Williamsburg, VA, USA
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Lee C, Ryff CD. Pathways linking combinations of early-life adversities to adult mortality: Tales that vary by gender. Soc Sci Med 2019; 240:112566. [PMID: 31585378 DOI: 10.1016/j.socscimed.2019.112566] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 08/05/2019] [Accepted: 09/21/2019] [Indexed: 11/17/2022]
Abstract
RATIONALE Socioeconomic disadvantage, family instability, and abuse are widely studied early-life adversities (ELAs) that may co-occur in the lives of many. The detrimental effects of these adversities may result in elevated risk of mortality in midlife and old age. OBJECTIVE We investigate how combinations of these three ELAs affect later-life mortality and the life-course mediators that explain the associations. METHOD Data come from the first two waves of the Midlife in the United States (MIDUS) study and mortality records over a 20-year period (1995/96-2015). We used latent class analysis (LCA) to identify patterns of ELAs across the three domains and incorporated four life-course mediators: material, psychological, social resources, healthy lifestyle and substance abuse. RESULTS LCA yielded six distinct combinations of ELAs, with patterns of socioeconomic status (SES) and abuse being most salient. We found that childhood abuse exists across all levels of childhood SES. For both genders, individuals who experienced low SES combined with frequent abuse have the highest risk of death. For women but not men, frequent abuse increases the risk of mortality even if they grew up in middle or high SES families. For both genders, material resource is a significant contributor on the pathway from ELAs to mortality. Life-course mediators partially accounted for the observed associations between ELAs and mortality, but attenuation was stronger for men than women. This is partially attributed to the stronger direct effects of life-course resources on mortality for men than women. CONCLUSIONS Our findings suggest that ELAs are an important determinant of mortality in midlife and old age. Traumatic experiences during the critical period of early life may compromise later-life heath more for women than men.
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Affiliation(s)
- Chioun Lee
- Department of Sociology, University of California-Riverside, USA.
| | - Carol D Ryff
- Institute on Aging, University of Wisconsin, Madison, USA
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