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Jorgensen JA, Choo-Kang C, Wang L, Issa L, Gilbert JA, Ecklu-Mensah G, Luke A, Bedu-Addo K, Forrester T, Bovet P, Lambert EV, Rae D, Argos M, Kelly TN, Sargis RM, Dugas LR, Dai Y, Layden BT. Toxic Metals Impact Gut Microbiota and Metabolic Risk in Five African-Origin Populations. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.10.07.24315016. [PMID: 39417117 PMCID: PMC11483006 DOI: 10.1101/2024.10.07.24315016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 10/19/2024]
Abstract
Exposure to toxic metals impacts obesity and type 2 diabetes (T2DM) risk. Yet, the underlying mechanisms remain largely unknown. Gut microbiota has been strongly associated with progression of cardiometabolic risk. To determine whether high metal exposures and gut dysbiosis interact to promote metabolic dysregulation and cardiometabolic risk, we assessed relationships between these factors. We analyzed cross-sectional associations between arsenic, lead, mercury, cadmium, and cardiometabolic health markers in 178 randomly selected African-origin adults (52% female, 51% obese, mean age=43.0±6.4 years) from Ghana, South Africa, Seychelles, Jamaica, and USA. Metal levels were dichotomized to high or low at the median level of each metal. We analyzed associations between gut microbiome taxa, metal levels, clinical measures (BMI, fasting blood glucose, and blood pressure) and diagnoses (hypertension, obesity, and diabetes status). High vs. low lead and arsenic exposures had a significant effect on beta diversity (p <0.05). 71 taxa were associated with high lead levels: 30 with elevated BMI, 22 with T2DM, and 23 with elevated fasting blood glucose (p<0.05). 115 taxa were associated with high arsenic levels: 32 with elevated BMI, 33 with T2DM, and 26 with elevated blood glucose (p<0.05). Of the taxa associated with high lead and arsenic exposure and either elevated BMI or fasting blood glucose, porphyrin metabolism was the most enriched metabolic pathway. These data collectively provide the first findings in a human study that the gut microbiome may drive the association between lead and arsenic exposure and obesity and T2DM risk.
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Affiliation(s)
| | - Candice Choo-Kang
- Public Health Sciences, Parkinson School of Health Sciences and Public Health, Loyola University Chicago, Maywood, IL, USA
| | - Luyu Wang
- University of Illinois Chicago, Chicago, IL, USA
| | - Lina Issa
- University of Illinois Chicago, Chicago, IL, USA
| | | | | | - Amy Luke
- Public Health Sciences, Parkinson School of Health Sciences and Public Health, Loyola University Chicago, Maywood, IL, USA
| | - Kweku Bedu-Addo
- Department of Physiology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Terrence Forrester
- Solutions for Developing Countries, University of the West Indies, Mona, Kingston, Jamaica
| | - Pascal Bovet
- University Center for General Medicine and Public Health (Unisanté), Lausanne, Switzerland
- Ministry of Health, Mahé, Victoria, Republic of Seychelles
| | - Estelle V Lambert
- Division of Epidemiology and Biostatistics, School of Public Health, University of Cape Town, Cape Town, South Africa
| | - Dale Rae
- Division of Epidemiology and Biostatistics, School of Public Health, University of Cape Town, Cape Town, South Africa
| | - Maria Argos
- School of Public Health, Boston University, Boston, MA, USA
| | | | - Robert M Sargis
- University of Illinois Chicago, Chicago, IL, USA
- Jesse Brown Veterans Administration, Chicago, IL, USA
| | - Lara R Dugas
- Public Health Sciences, Parkinson School of Health Sciences and Public Health, Loyola University Chicago, Maywood, IL, USA
- Division of Epidemiology and Biostatistics, School of Public Health, University of Cape Town, Cape Town, South Africa
| | - Yang Dai
- University of Illinois Chicago, Chicago, IL, USA
| | - Brian T Layden
- University of Illinois Chicago, Chicago, IL, USA
- Jesse Brown Veterans Administration, Chicago, IL, USA
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2
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Perrier A, Kakar A, Brown NR, Wingate LT. Utilizing Relative Autonomy Index Scores to Evaluate the Impact of Age on Motivation to Exercise in Black Women. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-02154-2. [PMID: 39230654 DOI: 10.1007/s40615-024-02154-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 07/31/2024] [Accepted: 08/25/2024] [Indexed: 09/05/2024]
Abstract
BACKGROUND Black women are disproportionately affected by overweight and obesity. One theory that may have utility in increasing the amount of exercise among Black women is self-determination theory, a psychology-based theory commonly used to investigate motivation in the context of exercise. The objective of this study was to determine whether motivation towards exercise behavior differs between younger and older Black women. METHODS A cross-sectional study was conducted by administering a survey to Black women in the Midwestern United States to elicit factors which may impact their motivation to exercise. The survey consisted of questions to gather sociodemographic information as well as responses to the Behavioral Regulations in Exercise Questionnaire (BREQ-2). Responses on the BREQ-2 were utilized to derive the Relative Autonomy Index (RAI) which is a direct measure of self-determination that provides insight into the extent of an individual's motivation to exercise. Multiple linear regression was utilized to determine if age was predictive of relative RAI scores after adjusting for marital status and receipt of a memorable message regarding health. RESULTS Mean RAI scores among respondents at least 40 years old were significantly higher in comparison to the RAI among respondents younger than 40. When adjusting for marital status and receipt of a memorable message regarding health, women at least 40 had a mean RAI score approximately 4.2 points higher than those under age 40. Women at least 40 years of age also had significantly higher scores on the identified regulation and intrinsic regulation subscales of the BREQ-2 questionnaire when compared to women younger than 40 after adjusting for marital status and recalling a memorable message related to health. CONCLUSION These findings suggest that exercise motivations differ among age groups of Black women. Additionally, these results highlight the importance of understanding exercise motivations to further improve health outcomes.
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Affiliation(s)
| | - Aishwarya Kakar
- Global Medical Information Manager, AbbVie, Chicago, IL, USA
| | - Natasha R Brown
- Department of Communication, Indiana University Northwest, Gary, IN, USA.
| | - La'Marcus T Wingate
- Department of Clinical and Administrative Pharmacy Sciences, College of Pharmacy, Howard University, Washington, USA
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Skinner JA, Whatnall M, Leary M, Collins RA, Pursey KM, Verdejo-García A, Hay PJ, Baker AL, Hides L, Paxton SJ, Wood LG, Colyvas K, Collins CE, Burrows TL. Examining the efficacy of a telehealth intervention targeting addictive eating in Australian adults (the TRACE Programme): a randomised controlled trial protocol. BMJ Open 2023; 13:e064151. [PMID: 37280025 PMCID: PMC10255192 DOI: 10.1136/bmjopen-2022-064151] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 05/16/2023] [Indexed: 06/08/2023] Open
Abstract
INTRODUCTION Approximately 15%-20% of the adult population self-report symptoms of addictive eating. There are currently limited options for management. Motivational interviewing-based interventions, containing personalised coping skills training, have been found to be effective for behaviour change in addictive disorders (eg, alcohol). This project builds upon foundations of an addictive eating feasibility study previously conducted and co-design process involving consumers. The primary aim of this study is to examine the efficacy of a telehealth intervention targeting addictive eating symptoms in Australian adults compared with passive intervention and control groups. METHODS AND ANALYSIS This three-arm randomised controlled trial will recruit participants 18-85 years, endorsing ≥3 symptoms on the Yale Food Addiction Scale (YFAS) 2.0, with body mass index >18.5 kg/m2. Addictive eating symptoms are assessed at baseline (pre-intervention), 3 months (post-intervention) and 6 months. Other outcomes include dietary intake and quality, depression, anxiety, stress, quality of life, physical activity and sleep hygiene. Using a multicomponent clinician-led approach, the active intervention consists of five telehealth sessions (15-45 min each) delivered by a dietitian over 3 months. The intervention uses personalised feedback, skill-building exercises, reflective activities and goal setting. Participants are provided with a workbook and website access. The passive intervention group receives the intervention via a self-guided approach with access to the workbook and website (no telehealth). The control group receives personalised written dietary feedback at baseline and participants advised to follow their usual dietary pattern for 6 months. The control group will be offered the passive intervention after 6 months. The primary endpoint is YFAS symptom scores at 3 months. A cost-consequence analysis will determine intervention costs alongside mean change outcomes. ETHICS AND DISSEMINATION Human Research Ethics Committee of University of Newcastle, Australia provided approval (H-2021-0100). Findings will be disseminated via publication in peer-reviewed journals, conference presentations, community presentations and student theses. TRIAL REGISTRATION NUMBER Australia New Zealand Clinical Trials Registry (ACTRN12621001079831).
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Affiliation(s)
- Janelle A Skinner
- School of Health Sciences, The University of Newcastle, Callaghan, New South Wales, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Megan Whatnall
- School of Health Sciences, The University of Newcastle, Callaghan, New South Wales, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Mark Leary
- School of Health Sciences, The University of Newcastle, Callaghan, New South Wales, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Rebecca A Collins
- School of Health Sciences, The University of Newcastle, Callaghan, New South Wales, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Kirrilly M Pursey
- School of Health Sciences, The University of Newcastle, Callaghan, New South Wales, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Antonio Verdejo-García
- School of Psychological Sciences and the Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia
| | - Phillipa J Hay
- Translational Health Research Institute and School of Medicine, Western Sydney University, Penrith South, New South Wales, Australia
| | - Amanda L Baker
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Leanne Hides
- School of Psychology, University of Queensland, Brisbane, Queensland, Australia
| | - Susan J Paxton
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Lisa G Wood
- School of Biomedical Sciences and Pharmacy, The University of Newcastle, Callaghan, New South Wales, Australia
- Viruses, Infections / Immunity, Vaccines and Asthma Research Program, Hunter Medical Research Institute, New Lambton, New South Wales, Australia
| | - Kim Colyvas
- School of Mathematical and Physical Sciences, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Clare E Collins
- School of Health Sciences, The University of Newcastle, Callaghan, New South Wales, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Tracy L Burrows
- School of Health Sciences, The University of Newcastle, Callaghan, New South Wales, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
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Strings S, Wells C, Bell C, Tomiyama AJ. The association of body mass index and odds of type 2 diabetes mellitus varies by race/ethnicity. Public Health 2023; 215:27-30. [PMID: 36634403 PMCID: PMC12050112 DOI: 10.1016/j.puhe.2022.11.017] [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: 05/31/2022] [Revised: 11/14/2022] [Accepted: 11/25/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVE This study aimed to examine the association between body mass index (BMI; weight [kilogram]/height2 [meter]) and type 2 diabetes mellitus (T2DM) among the largest three largest racial/ethnic groups in the United States. METHODS We compiled 10 waves of the continuous National Health and Nutrition Examination Survey from 1999-2000 through 2017-2018. Participants (N = 45,514) were those who had data on BMI, HbA1c, and demographics. We estimated associations between BMI and prediabetes/T2DM odds for Black, Latine, and White participants. RESULTS BMI was associated with 10% higher odds of prediabetes/T2DM vs. having normal HbA1c levels (odds ratio = 1.10, 95% confidence interval = 1.10-1.11) for Latine and White individuals. However, the association between BMI and prediabetes/T2DM was significantly weaker among Black individuals. When focusing on T2DM prevalence, the association with BMI for Black participants was even weaker (odds ratio = 0.97, 95% confidence interval = 0.95-0.98). CONCLUSIONS The unstable associations between BMI and T2DM across race indicate that BMI has received unwarranted focus as a prime predictor of T2DM. Relying on BMI introduces bias in T2DM risk estimations especially in Black individuals. Focusing on BMI places the onus on individuals to change and increases weight stigma, which can worsen health outcomes. Instead, policymakers should focus on social determinants of T2DM and its concomitant racial/ethnic disparities.
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Affiliation(s)
- S Strings
- Department of Sociology, 3151 Social Sciences Plaza A, University of California, Irvine, Irvine CA 92697, USA.
| | - C Wells
- Advanced Research Computing, University of California, Los Angeles, Los Angeles CA, USA
| | - C Bell
- Social, Behavioral, and Population Sciences, School of Public Health & Tropical Medicine, Tulane University, New Orleans LA, USA
| | - A J Tomiyama
- Department of Psychology, University of California, Los Angeles, Los Angeles CA, USA
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5
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Zendels P, Moore-Harrison T, Gaultney JF. Sleep and Risk for Metabolic Syndrome, Hypertension, Diabetes and Obesity Among Community-Dwelling Older Adults. INTERNATIONAL JOURNAL OF EXERCISE SCIENCE 2021; 15:88-102. [PMID: 36895436 PMCID: PMC9987437 DOI: 10.70252/oddb8638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/15/2025]
Abstract
Older adults often face a variety of health problems that are found less frequently in younger populations. Metabolic syndrome and other related diseases are common due to a variety of age and lifestyle factors. Sleep, often operationalized only as duration, quality, or apnea diagnosis, is associated with worse health outcomes across the lifespan. However, sleep is multi-faceted and may require a collection of measures in order to reflect this. This study examined a suite of self-reported sleep habits (risk for sleep apnea, night time duration, nap duration, quality, timing, and consistency of duration and timing) and physiological data in a sample of 144 older adults. Sleep-related variables as a group predicted risk for metabolic syndrome, hypertension, and diabetes but was not a clear predictor of obesity. Of the individual measures, risk for apnea and consistency of sleep duration throughout the week predicted risk for metabolic syndrome (apnea b = .64, p < .05; duration inconsistencies b = .22, p < .05). The findings of the study suggest that greater consistency in sleep schedules may benefit the health of older adult populations' risk for these disorders.
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Affiliation(s)
- Philip Zendels
- Health Psychology and Psychological Sciences, University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Trudy Moore-Harrison
- Applied Physiology, Health and Clinical Sciences, University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Jane F Gaultney
- Health Psychology and Psychological Sciences, University of North Carolina at Charlotte, Charlotte, NC, USA
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6
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Zurita T, Kazmierski KFM, Wong L, Faulkner M, Kuo S, Huszti H, Rao U. Racial/ethnic differences in dietary intake among a diverse sample of adolescents: An experimental study. Pediatr Obes 2021; 16:e12823. [PMID: 34121364 PMCID: PMC8563420 DOI: 10.1111/ijpo.12823] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 05/10/2021] [Accepted: 05/14/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND African-American (AA) and Hispanic/Latina (HL) females have higher obesity prevalence than do non-Hispanic Whites (NHW); this may be due to AA and HL consuming more energy-dense foods in response to stressors. OBJECTIVES This study examined racial/ethnic differences in dietary intake under controlled conditions (relaxation and stress) in a diverse sample of adolescent females. METHODS Participants included 120 adolescent females (30% AA, 37% HL and 33% NHW) who participated in a laboratory food intake study. Using a randomized cross-over design, ad libitum food consumption was measured following control/relaxation and social-evaluative stress conditions. Food intake was indexed as consumed calories, added sugars and solid fats. RESULTS The effect of laboratory conditions on food intake varied by race/ethnicity, such that AA consumed more energy following relaxation than following stress. For NHW and HL, food intake did not differ between conditions. CONCLUSIONS To the best of our knowledge, these findings are the first to directly observe racial/ethnic differences in food intake in response to acute stress, which may contribute to obesity-related health disparities.
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Affiliation(s)
- Tomas Zurita
- Department of Psychiatry and Human Behavior, University of California Irvine (UCI), Irvine, California
| | - Kelly F. M. Kazmierski
- Department of Psychiatry and Human Behavior, University of California Irvine (UCI), Irvine, California
| | - Larissa Wong
- Department of Psychiatry and Human Behavior, University of California Irvine (UCI), Irvine, California
| | - Megan Faulkner
- Department of Psychiatry and Human Behavior, University of California Irvine (UCI), Irvine, California
| | - Sabrina Kuo
- Department of Psychiatry and Human Behavior, University of California Irvine (UCI), Irvine, California
| | - Heather Huszti
- Children’s Hospital of Orange County, Orange, California
| | - Uma Rao
- Department of Psychiatry and Human Behavior, University of California Irvine (UCI), Irvine, California,Children’s Hospital of Orange County, Orange, California,Department of Pediatrics, University of California Irvine, Irvine, California,Department of Psychological Science, University of California Irvine, Irvine, California,Center for the Neurobiology of Learning and Memory, University of California Irvine, Irvine, California
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7
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Min SH, Whittemore R, Kennedy HP, Nam S. Reflections on obesity-related health behaviors over time and suggestions for health promotion programs from African American women. J Women Aging 2021; 34:487-500. [PMID: 34495818 DOI: 10.1080/08952841.2021.1974268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
African American (AA) women have the highest rate of obesity in the United States. To date, there are mixed findings on AA women's perception on obesity and their perceived changes in health behaviors over time that may have contributed to obesity. Therefore, the aims of this current qualitative descriptive study were to explore: 1) AA women's perception on obesity and perceived changes in health behaviors related to obesity through their reflection on life; 2) AA women's perceived facilitators and barriers to maintaining healthy behaviors; and 3) AA women's suggestions for future health promotion programs to manage obesity. Semi-structured interviews with ended questions were conducted with 21 AA women. Luborsky's method for thematic analysis was used to analyze data. Three main themes with subthemes were identified. First main theme was the AA culture that served as a facilitator and barrier to maintaining healthy lifestyle from childhood to young adulthood. Second main theme was gradual changes in their healthy lifestyle due to social and physical environment from young adulthood to middle adulthood. Third main theme was AA women's various suggestions for future health promotion programs. This study found obesity to be a multifactorial phenomenon that is a result of complex interaction of culture, environment, and social networks. Therefore, clinicians need to address the issue of obesity from a holistic perspective for AA women to actively engage with their primary health care. Future health promotion programs should incorporate culturally tailored lifestyle components and increase knowledge on healthy lifestyle against obesity through community-based programs.
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Affiliation(s)
- Se Hee Min
- School of Nursing, Duke University, Durham, North Carolina, USA
| | | | | | - Soohyun Nam
- School of Nursing, Yale University, Orange, Connecticut, USA
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8
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Kazmierski KFM, Gillespie ML, Kuo S, Zurita T, Felix D, Rao U. Stress-Induced Eating Among Racial/Ethnic Groups in the United States: a Systematic Review. J Racial Ethn Health Disparities 2021; 8:912-926. [PMID: 32839895 PMCID: PMC7902740 DOI: 10.1007/s40615-020-00849-w] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 08/11/2020] [Accepted: 08/12/2020] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Racial/ethnic disparities in obesity may be due, in part, to minority groups consuming more energy-rich diets in response to greater stress exposure. The present study systematically reviewed the literature describing the effects of stress on food consumption among various racial/ethnic groups in the US. METHODS PubMed and PsycINFO databases were searched for studies reporting associations between stress and food consumption by different racial/ethnic groups, conducted between January 1, 1999 to November 25, 2019. The search included terms related to food consumption, stress, and race/ethnicity. After screening 3660 records, 30 studies were included for review. RESULTS The selected studies assessed diverse stressors and eating constructs; African-American and Hispanic/Latinx were the most commonly studied minority groups. Studies generally supported that diverse forms of stress exposure are associated with reduced healthy eating patterns and increased obesogenic eating patterns across racial/ethnic groups. However, studies that directly compared stress-eating associations among multiple racial/ethnic groups showed mixed results. CONCLUSION Members of diverse racial/ethnic groups are susceptible to stress-induced unhealthy eating patterns, though evidence is insufficient to conclude whether the degree of susceptibility differs among groups. Additional studies utilizing observational measures of food intake and culturally sensitive measures of stress are needed to identify the most influential stressors on dietary behaviors, to assess whether some stressors are more salient for given racial/ethnic groups, and to examine the extent to which stress-induced eating contributes to racial/ethnic disparities in obesity and obesity-related diseases.
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Affiliation(s)
- Kelly F M Kazmierski
- Department of Psychiatry & Human Behavior, College of Health Sciences, School of Medicine, University of California, Irvine, CA, USA
| | - Marie L Gillespie
- Department of Psychiatry & Human Behavior, College of Health Sciences, School of Medicine, University of California, Irvine, CA, USA
| | - Sabrina Kuo
- Department of Psychiatry & Human Behavior, College of Health Sciences, School of Medicine, University of California, Irvine, CA, USA
| | - Tomas Zurita
- Department of Psychiatry & Human Behavior, College of Health Sciences, School of Medicine, University of California, Irvine, CA, USA
| | - Dania Felix
- Department of Psychiatry & Human Behavior, College of Health Sciences, School of Medicine, University of California, Irvine, CA, USA
| | - Uma Rao
- Department of Psychiatry & Human Behavior, College of Health Sciences, School of Medicine, University of California, Irvine, CA, USA.
- Children's Hospital of Orange County, Orange, CA, USA.
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9
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Vydiswaran VGV, Romero DM, Zhao X, Yu D, Gomez-Lopez I, Lu JX, Iott BE, Baylin A, Jansen EC, Clarke P, Berrocal VJ, Goodspeed R, Veinot TC. Uncovering the relationship between food-related discussion on Twitter and neighborhood characteristics. J Am Med Inform Assoc 2021; 27:254-264. [PMID: 31633756 PMCID: PMC7025333 DOI: 10.1093/jamia/ocz181] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 09/11/2019] [Accepted: 09/27/2019] [Indexed: 12/20/2022] Open
Abstract
Objective Initiatives to reduce neighborhood-based health disparities require access to meaningful, timely, and local information regarding health behavior and its determinants. We examined the validity of Twitter as a source of information for neighborhood-level analysis of dietary choices and attitudes. Materials and Methods We analyzed the “healthiness” quotient and sentiment in food-related tweets at the census tract level, and associated them with neighborhood characteristics and health outcomes. We analyzed keywords driving the differences in food healthiness between the most and least-affluent tracts, and qualitatively analyzed contents of a random sample of tweets. Results Significant, albeit weak, correlations existed between healthiness and sentiment in food-related tweets and tract-level measures of affluence, disadvantage, race, age, U.S. density, and mortality from conditions associated with obesity. Analyses of keywords driving the differences in food healthiness revealed foods high in saturated fat (eg, pizza, bacon, fries) were mentioned more frequently in less-affluent tracts. Food-related discussion referred to activities (eating, drinking, cooking), locations where food was consumed, and positive (affection, cravings, enjoyment) and negative attitudes (dislike, personal struggles, complaints). Discussion Tweet-based healthiness scores largely correlated with offline phenomena in the expected directions. Social media offer less resource-intensive data collection methods than traditional surveys do. Twitter may assist in informing local health programs that focus on drivers of food consumption and could inform interventions focused on attitudes and the food environment. Conclusions Twitter provided weak but significant signals concerning food-related behavior and attitudes at the neighborhood level, suggesting its potential usefulness for informing local health disparity reduction efforts.
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Affiliation(s)
- V G Vinod Vydiswaran
- Department of Learning Health Sciences, University of Michigan, Ann Arbor, Michigan, USA.,School of Information, University of Michigan, Ann Arbor, Michigan, USA
| | - Daniel M Romero
- School of Information, University of Michigan, Ann Arbor, Michigan, USA.,Center for the Study of Complex Systems, University of Michigan, Ann Arbor, Michigan, USA.,Department of Electrical Engineering and Computer Science, University of Michigan, Ann Arbor, Michigan, USA
| | - Xinyan Zhao
- School of Information, University of Michigan, Ann Arbor, Michigan, USA
| | - Deahan Yu
- School of Information, University of Michigan, Ann Arbor, Michigan, USA
| | - Iris Gomez-Lopez
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Jin Xiu Lu
- School of Information, University of Michigan, Ann Arbor, Michigan, USA
| | - Bradley E Iott
- School of Information, University of Michigan, Ann Arbor, Michigan, USA.,Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Ana Baylin
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA.,Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Erica C Jansen
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Philippa Clarke
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA.,Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Veronica J Berrocal
- Department of Statistics, Donald Bren School of Information and Computer Science, University of California, Irvine, California, USA
| | - Robert Goodspeed
- Urban and Regional Planning Program, Taubman College of Architecture and Urban Planning, University of Michigan, Ann Arbor, Michigan, USA
| | - Tiffany C Veinot
- School of Information, University of Michigan, Ann Arbor, Michigan, USA.,Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
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10
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Schering T, Schiffer L, McLeod A, DeMott A, Hughes S, Fitzgibbon ML, Tussing-Humphreys L. Association of diet quality and physical function among overweight and obese primarily African American older adults with lower extremity osteoarthritis. NUTRITION AND HEALTHY AGING 2021; 6:61-71. [PMID: 33709042 PMCID: PMC7903244 DOI: 10.3233/nha-190081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Strategies to reduce osteoarthritis (OA) symptoms and increase physical function in persons with lower extremity (LE) OA is a public health priority. OBJECTIVE To examine associations between diet quality and measures of physical function among overweight and obese older adults with self-reported LE OA. METHODS 413 overweight and obese primarily African American adults ≥60 years old with LE OA were assessed. Diet quality was quantified using the Healthy Eating Index-2010 (HEI-2010) and Alternative Healthy Eating Index-2010 (AHEI-2010). The six-minute walk, 30-second chair-stands, and timed up-and-go tests were used to assess physical function. Unadjusted and multivariable linear regressions were performed to assess associations between the diet quality and measures of physical function. RESULTS The mean age of the subjects was 67.8 (SD 5.9) years and mean BMI was 34.8 (SD 5.5) kg/m2. Adjusting for total calories, AHEI-2010 total score was associated with superior performance on the six-minute walk test. However, the association was attenuated when also controlling for age, gender, BMI, waist circumference, self-reported pain, and physical activity. HEI-2010 was not associated with the physical function measures. CONCLUSION AHEI-2010 total score was positively associated with walking speed among older overweight and obese primarily AA older adults with LE OA. However, the association weakened when adjusting for subject covariates. The relationship between diet quality and physical function among health disparate populations should be further investigated in larger cohorts and using rigorous experimental study design.
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Affiliation(s)
- Teresa Schering
- Department of Medicine, Chicago IL, USA
- Department of Epidemiology, School of Public Health, University of Illinois at Chicago, Chicago, IL, USA
- University of Illinois Cancer Center, University of Illinois at Chicago, Chicago, IL, USA
| | - Linda Schiffer
- Institute for Health Research and Policy, Chicago, IL, USA
| | - Andrew McLeod
- Institute for Health Research and Policy, Chicago, IL, USA
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, USA
| | - Andrew DeMott
- Center for Research on Health and Aging, Institute for Health Research Policy, University of Illinois at Chicago, Chicago, IL, USA
| | - Susan Hughes
- Center for Research on Health and Aging, Institute for Health Research Policy, University of Illinois at Chicago, Chicago, IL, USA
- Department of Community Health Sciences, School of Public Health, University of Illinois at Chicago, Chicago, IL, USA
| | - Marian L. Fitzgibbon
- University of Illinois Cancer Center, University of Illinois at Chicago, Chicago, IL, USA
- Institute for Health Research and Policy, Chicago, IL, USA
- Department of Pediatrics, University of Illinois at Chicago, Chicago, IL, USA
| | - Lisa Tussing-Humphreys
- University of Illinois Cancer Center, University of Illinois at Chicago, Chicago, IL, USA
- Institute for Health Research and Policy, Chicago, IL, USA
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, USA
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11
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Matossian MD, Giardina AA, Wright MK, Elliott S, Loch MM, Nguyen K, Zea AH, Lau FH, Moroz K, Riker AI, Jones SD, Martin EC, Bunnell BA, Miele L, Collins-Burow BM, Burow ME. Patient-Derived Xenografts as an Innovative Surrogate Tumor Model for the Investigation of Health Disparities in Triple Negative Breast Cancer. ACTA ACUST UNITED AC 2020; 1:383-392. [PMID: 33786503 PMCID: PMC7784803 DOI: 10.1089/whr.2020.0037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2020] [Indexed: 12/24/2022]
Abstract
Despite a decline in overall incidence rates for cancer in the past decade, due in part to impressive advancements in both diagnosis and treatment, breast cancer (BC) remains the leading cause of cancer-related deaths in women. BC alone accounts for ∼30% of all new cancer diagnoses in women worldwide. Triple-negative BC (TNBC), defined as having no expression of the estrogen or progesterone receptors and no amplification of the HER2 receptor, is a subtype of BC that does not benefit from the use of estrogen receptor-targeting or HER2-targeting therapies. Differences in socioeconomic factors and cell intrinsic and extrinsic characteristics have been demonstrated in Black and White TNBC patient tumors. The emergence of patient-derived xenograft (PDX) models as a surrogate, translational, and functional representation of the patient with TNBC has led to the advances in drug discovery and testing of novel targeted approaches and combination therapies. However, current established TNBC PDX models fail to represent the diverse patient population and, most importantly, the specific ethnic patient populations that have higher rates of incidence and mortality. The primary aim of this review is to emphasize the importance of using clinically relevant translatable tumor models that reflect TNBC human tumor biology and heterogeneity in high-risk patient populations. The focus is to highlight the complexity of BC as it specifically relates to the management of TNBC in Black women. We discuss the importance of utilizing PDX models to study the extracellular matrix (ECM), and the distinct differences in ECM composition and biophysical properties in Black and White women. Finally, we demonstrate the crucial importance of PDX models toward novel drug discovery in this patient population.
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Affiliation(s)
- Margarite D Matossian
- Section of Hematology and Oncology, Department of Medicine, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Alexandra A Giardina
- Biospecimen Core Laboratory, Louisiana Cancer Research Center, New Orleans, Louisiana, USA
| | - Maryl K Wright
- Section of Hematology and Oncology, Department of Medicine, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Steven Elliott
- Section of Hematology and Oncology, Department of Medicine, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Michelle M Loch
- Section of Hematology and Oncology, Department of Medicine, Louisiana State University Health Sciences Center, School of Medicine, New Orleans, Louisiana, USA
| | - Khoa Nguyen
- Section of Hematology and Oncology, Department of Medicine, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Arnold H Zea
- Biospecimen Core Laboratory, Louisiana Cancer Research Center, New Orleans, Louisiana, USA.,Department of Genetics and Stanley S. Scott Cancer Center, Louisiana Health Sciences Center, New Orleans, Louisiana, USA
| | - Frank H Lau
- Department of Surgery, Louisiana State University Health Sciences Center, School of Medicine, New Orleans, Louisiana, USA
| | - Krzysztof Moroz
- Biospecimen Core Laboratory, Louisiana Cancer Research Center, New Orleans, Louisiana, USA.,Department of Pathology, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Adam I Riker
- Department of Surgery, Louisiana State University Health Sciences Center, School of Medicine, New Orleans, Louisiana, USA.,Department of Surgery, DeCesaris Cancer Institute, Anne Arundel Medical Center, Luminis Health, Annapolis, Maryland, USA
| | - Steven D Jones
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Elizabeth C Martin
- Department of Biological & Agricultural Engineering, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Bruce A Bunnell
- Department of Pharmacology, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Lucio Miele
- Department of Genetics and Stanley S. Scott Cancer Center, Louisiana Health Sciences Center, New Orleans, Louisiana, USA
| | - Bridgette M Collins-Burow
- Section of Hematology and Oncology, Department of Medicine, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Matthew E Burow
- Section of Hematology and Oncology, Department of Medicine, Tulane University School of Medicine, New Orleans, Louisiana, USA.,Department of Pharmacology, Tulane University School of Medicine, New Orleans, Louisiana, USA
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12
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Nono Nankam PA, Blüher M, Kehr S, Klöting N, Krohn K, Adams K, Stadler PF, Mendham AE, Goedecke JH. Distinct abdominal and gluteal adipose tissue transcriptome signatures are altered by exercise training in African women with obesity. Sci Rep 2020; 10:10240. [PMID: 32581226 PMCID: PMC7314771 DOI: 10.1038/s41598-020-66868-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 05/28/2020] [Indexed: 01/09/2023] Open
Abstract
The differential associations of adipose depots with metabolic risk during obesity have been proposed to be controlled by environmental and genetic factors. We evaluated the regional differences in transcriptome signatures between abdominal (aSAT) and gluteal subcutaneous adipose tissue (gSAT) in obese black South African women and tested the hypothesis that 12-week exercise training alters gene expression patterns in a depot-specific manner. Twelve young women performed 12-weeks of supervised aerobic and resistance training. Pre- and post-intervention measurements included peak oxygen consumption (VO2peak), whole-body composition and unbiased gene expression analysis of SAT depots. VO2peak increased, body weight decreased, and body fat distribution improved with exercise training (p < 0.05). The expression of 15 genes, mainly associated with embryonic development, differed between SAT depots at baseline, whereas 318 genes were differentially expressed post-training (p < 0.05). Four developmental genes were differentially expressed between these depots at both time points (HOXA5, DMRT2, DMRT3 and CSN1S1). Exercise training induced changes in the expression of genes associated with immune and inflammatory responses, and lipid metabolism in gSAT, and muscle-associated processes in aSAT. This study showed differences in developmental processes regulating SAT distribution and expandability of distinct depots, and depot-specific adaptation to exercise training in black South African women with obesity.
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Affiliation(s)
- Pamela A Nono Nankam
- Division of Exercise Science and Sports Medicine, Department of Human Biology, University of Cape Town, Cape Town, South Africa. .,Department of Endocrinology, Faculty of Medicine, University of Leipzig, Leipzig, Germany.
| | - Matthias Blüher
- Department of Endocrinology, Faculty of Medicine, University of Leipzig, Leipzig, Germany.,Helmholtz Institute for Metabolic, Obesity and Vascular Research (HI-MAG) of the Helmholtz Zentrum München at the University of Leipzig and University Hospital Leipzig, Leipzig, Germany
| | - Stephanie Kehr
- Bioinformatics Group, Department of Computer Science, and Interdisciplinary Center for Bioinformatics, University of Leipzig, Leipzig, Germany
| | - Nora Klöting
- Department of Endocrinology, Faculty of Medicine, University of Leipzig, Leipzig, Germany.,Helmholtz Institute for Metabolic, Obesity and Vascular Research (HI-MAG) of the Helmholtz Zentrum München at the University of Leipzig and University Hospital Leipzig, Leipzig, Germany
| | - Knut Krohn
- Core Unit DNA-Technologies, Medical Faculty, University Leipzig, Leipzig, Germany
| | - Kevin Adams
- Division of Exercise Science and Sports Medicine, Department of Human Biology, University of Cape Town, Cape Town, South Africa
| | - Peter F Stadler
- Bioinformatics Group, Department of Computer Science, and Interdisciplinary Center for Bioinformatics, University of Leipzig, Leipzig, Germany
| | - Amy E Mendham
- Division of Exercise Science and Sports Medicine, Department of Human Biology, University of Cape Town, Cape Town, South Africa.,Non-communicable Diseases Research Unit, South African Medical Research Council, Tygerberg, Cape Town, South Africa
| | - Julia H Goedecke
- Division of Exercise Science and Sports Medicine, Department of Human Biology, University of Cape Town, Cape Town, South Africa.,Non-communicable Diseases Research Unit, South African Medical Research Council, Tygerberg, Cape Town, South Africa
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13
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Nono Nankam PA, Mendham AE, De Smidt MF, Keswell D, Olsson T, Blüher M, Goedecke JH. Changes in systemic and subcutaneous adipose tissue inflammation and oxidative stress in response to exercise training in obese black African women. J Physiol 2020; 598:503-515. [PMID: 31873952 DOI: 10.1113/jp278669] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 12/17/2019] [Indexed: 12/20/2022] Open
Abstract
KEY POINTS Inflammation and oxidative stress are interrelated during obesity and contribute to the development of insulin resistance; and exercise training represents a key component in the management of these conditions. Black African women, despite high gluteal subcutaneous adipose tissue (SAT) and less visceral fat, are less insulin sensitive than their white counterparts. Exercise training improved systemic oxidative stress in obese black women, which was related to gynoid fat reduction and not insulin sensitivity. Inflammatory markers changed depot-specifically in response to exercise training, increasing in gluteal SAT without changing in abdominal SAT. The increase of inflammatory state in gluteal SAT after exercise training is suggested to result from tissue remodelling consecutive to the reduction of gynoid fat but does not contribute to the improvement of whole-body insulin sensitivity in obese black South African women. ABSTRACT Inflammation and oxidative stress are interrelated during obesity and contribute to the development of insulin resistance. Exercise training represents a key component in the management of obesity. We evaluated the effects of 12 weeks' combined resistance and aerobic exercise training on systemic and abdominal vs. gluteal subcutaneous adipose tissue (SAT) inflammatory and oxidative status in obese black South African women. Before and after the intervention, body composition (dual energy X-ray absorptiometry), cardio-respiratory fitness ( VO 2 peak ), serum and SAT inflammatory and oxidative stress markers were measured from 15 (control group) and 20 (exercise group) women and insulin sensitivity (SI ; frequently sampled intravenous glucose tolerance test) was estimated. Following the intervention, VO 2 peak (9.8%), body fat composition (1-3%) and SI (9%) improved, serum thiobarbituric acid reactive substances (TBARS) decreased (6.5%), and catalase activity increased (23%) in the exercise compared to the control group (P < 0.05), without changes in circulating inflammatory markers. The mRNA content of interleukin-10, tumour necrosis factor α, nuclear factor κB and macrophage migration inhibitory factor increased in the gluteal SAT exercise compared to the control group P < 0.05), with no changes in abdominal SAT. These changes of inflammatory profile in gluteal SAT, in addition to the reduction of circulating TBARS, correlated with the reduction of gynoid fat, but not with the improvement of SI . The changes in systemic oxidative stress markers and gluteal SAT inflammatory genes correlated with the reduction in gynoid fat but were not directly associated with the exercise-induced improvements in SI .
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Affiliation(s)
- Pamela A Nono Nankam
- Division of Exercise Science and Sports Medicine, Department of Human Biology, University of Cape Town, Cape Town, South Africa.,Department of Medicine, University of Leipzig, Leipzig, Germany
| | - Amy E Mendham
- Division of Exercise Science and Sports Medicine, Department of Human Biology, University of Cape Town, Cape Town, South Africa.,Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Melony F De Smidt
- Division of Exercise Science and Sports Medicine, Department of Human Biology, University of Cape Town, Cape Town, South Africa
| | - Dheshnie Keswell
- Division of Exercise Science and Sports Medicine, Department of Human Biology, University of Cape Town, Cape Town, South Africa
| | - Tommy Olsson
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Matthias Blüher
- Department of Medicine, University of Leipzig, Leipzig, Germany
| | - Julia H Goedecke
- Division of Exercise Science and Sports Medicine, Department of Human Biology, University of Cape Town, Cape Town, South Africa.,Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa
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14
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Bidulescu A, Ferguson TS, Hambleton I, Younger-Coleman N, Francis D, Bennett N, Griswold M, Fox E, MacLeish M, Wilks R, Harris EN, Sullivan LW. Educational health disparities in hypertension and diabetes mellitus among African descent populations in the Caribbean and the USA: a comparative analysis from the Spanish town cohort (Jamaica) and the Jackson heart study (USA). Int J Equity Health 2017; 16:33. [PMID: 28222733 PMCID: PMC5320798 DOI: 10.1186/s12939-017-0527-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Accepted: 02/01/2017] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Studies have suggested that social inequalities in chronic disease outcomes differ between industrialized and developing countries, but few have directly compared these effects. We explored inequalities in hypertension and diabetes prevalence between African-descent populations with different levels of educational attainment in Jamaica and in the United States of America (USA), comparing disparities within each location, and between countries. METHODS We analyzed baseline data from the Jackson Heart Study (JHS) in the USA and Spanish Town Cohort (STC) in Jamaica. Participants reported their highest level of educational attainment, which was categorized as 'less than high school' (HS). Educational disparities in the prevalence of hypertension and diabetes were examined using prevalence ratios (PR), controlling for age, sex and body mass index (BMI). RESULTS Analyses included 7248 participants, 2382 from STC and 4866 from JHS, with mean age of 47 and 54 years, respectively (p < 0.001). Prevalence for both hypertension and diabetes was significantly higher in the JHS compared to STC, 62% vs. 25% (p < 0.001) and 18% vs. 13% (p < 0.001), respectively. In bivariate analyses there were significant disparities by education level for both hypertension and diabetes in both studies; however, after accounting for confounding or interaction by age, sex and BMI these effects were attenuated. For hypertension, after adjusting for age and BMI, a significant education disparity was found only for women in JHS, with PR of 1.10 (95% CI 1.04-1.16) for < HS vs > HS and 1.07 (95% CI 1.01-1.13) for HS vs > HS. For diabetes; when considering age-group and sex specific estimates adjusted for BMI, among men: significant associations were seen only in the 45-59 years age-group in JHS with PR 1.84 (95% CI 1.16-2.91) for < HS vs > HS. Among women, significant PR comparing < HS to > HS was seen for all three age-groups for JHS, but not in STC; PR were 3.95 (95% CI 1.94-8.05), 1.53 (95% CI 1.10-2.11) and 1.32 (95% CI 1.06-1.64) for 25-44, 45-59 and 60-74 age-groups, respectively. CONCLUSION In Jamaica, educational disparities were largely explained by age, sex and BMI, while in the USA these disparities were larger and persisted after accounting these variables.
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Affiliation(s)
- Aurelian Bidulescu
- Department of Epidemiology and Biostatistics, Indiana University School of Public Health – Bloomington, Bloomington, IN USA
| | - Trevor S. Ferguson
- Epidemiology Research Unit, Tropical Medicine Research Institute, The University of the West Indies, Kingston, West Indies Jamaica
| | - Ian Hambleton
- Chronic Disease Research Centre, Tropical Medicine Research Institute, The University of the West Indies, Bridgetown, West Indies Barbados
| | - Novie Younger-Coleman
- Epidemiology Research Unit, Tropical Medicine Research Institute, The University of the West Indies, Kingston, West Indies Jamaica
| | - Damian Francis
- Epidemiology Research Unit, Tropical Medicine Research Institute, The University of the West Indies, Kingston, West Indies Jamaica
| | - Nadia Bennett
- Epidemiology Research Unit, Tropical Medicine Research Institute, The University of the West Indies, Kingston, West Indies Jamaica
| | - Michael Griswold
- Center of Biostatistics and Bioinformatics, University of Mississippi Medical Center, Jackson, MS USA
| | - Ervin Fox
- University of Mississippi Medical Center, Jackson, MS USA
| | - Marlene MacLeish
- Department of Medical Education, Morehouse School of Medicine, Atlanta, Georgia
| | - Rainford Wilks
- Epidemiology Research Unit, Tropical Medicine Research Institute, The University of the West Indies, Kingston, West Indies Jamaica
| | - E. Nigel Harris
- The University of the West Indies, Kingston, West Indies Jamaica
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15
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Powell LR, Jesdale WM, Lemon SC. On Edge: the impact of race-related vigilance on obesity status in African-Americans. Obes Sci Pract 2016; 2:136-143. [PMID: 27275395 PMCID: PMC4891700 DOI: 10.1002/osp4.42] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Objective Nearly half of African–Americans are classified as obese. Perceived racism has been associated with obesity, yet the internal experiences of racism have received little attention. African–Americans who face racism may ‘ready themselves’ to cope through survival strategies, including race‐related vigilance. This study explores the association between race‐related vigilance and obesity in African–Americans. Design and methods The Reactions to Race module of the Behavioral Risk Factor Surveillance Survey (years 2002–2010) was used. Our sample size consisted of 12,214 African–Americans. Race‐related vigilance was assessed as ‘How often do you think about your race?’ and classified as never, <daily, daily and >daily. Obesity was dichotomized as body mass index ≥ 30 kg m−2 vs. <30 kg m−2 using self‐reported weight and height. Multivariable logistic models assessed the association between race‐related vigilance and obesity. Results Seventeen percent of respondents reported thinking about their race >daily; 14% daily; 31% <daily and 39% reported never thinking about their race. Compared with those who reported never thinking about their race, the adjusted odds of obesity were 0.91, 95% CI: 0.72–1.15 among those thinking about their race <daily; 1.09, 95% CI: 0.81–1.46 among those thinking about their race daily; and 1.37, 95% CI: 1.07–1.76 among those thinking about their race >daily. Conclusions Frequently thinking about one's race was a risk factor for obesity in African–Americans in this study. Internalized impacts of racism captured through race‐related vigilance may be particularly detrimental to African–Americans, driving their risk for obesity.
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Affiliation(s)
- Lauren R Powell
- Clinical and Population Health Research Doctoral Program, Department of Quantitative Health Sciences, Department of Medicine, Division of Behavioral and Preventive Medicine, University of Massachusetts Medical School, Worcester, Massachusetts 01655 USA
| | - William M Jesdale
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts 01655 USA
| | - Stephenie C Lemon
- Department of Medicine, Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, Massachusetts 01655 USA, (508) 856-4098 - telephone, (508) 856-3840 - fax
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16
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Bandera EV, Qin B, Moorman PG, Alberg AJ, Barnholtz-Sloan JS, Bondy M, Cote ML, Funkhouser E, Peters ES, Schwartz AG, Terry P, Schildkraut JM. Obesity, weight gain, and ovarian cancer risk in African American women. Int J Cancer 2016; 139:593-600. [PMID: 27038123 DOI: 10.1002/ijc.30115] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2015] [Revised: 02/03/2016] [Accepted: 03/08/2016] [Indexed: 12/24/2022]
Abstract
Although there is growing evidence that higher adiposity increases ovarian cancer risk, little is known about its impact in African American (AA) women, the racial/ethnic group with the highest prevalence of obesity. We evaluated the impact of body mass index (BMI) 1 year before diagnosis and weight gain since age 18 years on ovarian cancer risk in a population-based case-control study in AA women in 11 geographical areas in the US. Cases (n = 492) and age and site matched controls (n = 696) were identified through rapid case ascertainment and random-digit-dialing, respectively. Information was collected on demographic and lifestyle factors, including self-reported height, weight at age 18 and weight 1 year before diagnosis/interview. Multivariable logistic regression was used to compute odds ratios (OR) and 95% confidence intervals (CI), adjusting for potential covariates. Obese women had elevated ovarian cancer risk, particularly for BMI ≥ 40 kg/m(2) compared to BMI <25 (OR = 1.72, 95% CI: 1.12-2.66; p for trend: 0.03). There was also a strong association with weight gain since age 18 (OR: 1.52; 95% CI: 1.07-2.16; p for trend: 0.02) comparing the highest to lowest quartile. In stratified analyses by menopausal status, the association with BMI and weight gain was limited to postmenopausal women, with a 15% (95% CI: 1.05-1.23) increase in risk per 5 kg/m(2) of BMI and 6% (95% CI: 1.01-1.10) increase in risk per 5 kg of weight gain. Excluding hormone therapy users essentially did not change results. Obesity and excessive adult weight gain may increase ovarian cancer risk in post-menopausal AA women.
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Affiliation(s)
- Elisa V Bandera
- Department of Population Science, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Bo Qin
- Department of Population Science, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Patricia G Moorman
- Department of Community and Family Medicine, Duke Cancer Institute, Durham, NC
| | - Anthony J Alberg
- Hollings Cancer Center and Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC
| | - Jill S Barnholtz-Sloan
- Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, OH
| | - Melissa Bondy
- Cancer Prevention and Population Sciences Program, Baylor College of Medicine, Houston, TX
| | - Michele L Cote
- Department of Oncology and the Karmanos Cancer Institute, Population Studies and Disparities Research Program, Wayne State University School of Medicine, Detroit, MI
| | - Ellen Funkhouser
- Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - Edward S Peters
- Epidemiology Program, Louisiana State University Health Sciences Center School of Public Health, New Orleans, LA
| | - Ann G Schwartz
- Department of Oncology and the Karmanos Cancer Institute, Population Studies and Disparities Research Program, Wayne State University School of Medicine, Detroit, MI
| | - Paul Terry
- Departments of Public Health and Surgery, University of Tennessee-Knoxville, Knoxville, TN
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17
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Ezeukwu AO, Agwubike EO. Anthropometric measures of adiposity as correlates of atherogenic index of plasma in non-obese sedentary Nigerian males. Libyan J Med 2014; 9:23798. [PMID: 24702831 PMCID: PMC3976532 DOI: 10.3402/ljm.v9.23798] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2014] [Accepted: 03/11/2014] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND The increase in cardiovascular events has necessitated the identification of possible predictors that can help in predicting atherogenicity. OBJECTIVE The study sought to identify the anthropometric measures of adiposity that are associated with atherogenic risk in sedentary, non-obese, young male adults. METHODS A cross-sectional design was used to recruit a purposive sample of 414 sedentary males in a university campus. Anthropometric measures of adiposity, lipid parameters, and atherogenic index of plasma (AIP) were assessed. Pearson correlation and stepwise multiple regression were used to analyze the data collected. Alpha level was set at p<0.05. RESULTS There was a high risk of cardiovascular events (AIP=0.36±0.04 SD) among the participants. A significant correlation (p=0.000) was obtained between each of the anthropometric measures (except conicity index) and AIP. Body mass index, body adiposity index, and percent body fat were significant predictors accounting for 38.9, 3.1, and 2.2% of the variance due to AIP. CONCLUSIONS Sedentary status among young males is associated with high atherogenic risk in the presence of normal lipid and anthropometric parameters. Both central and general measures of adiposity predict less than half of the atherogenic risk in sedentary young males.
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Affiliation(s)
- Antoninus O Ezeukwu
- Department of Medical Rehabilitation, Faculty of Health Sciences & Technology, University of Nigeria, Enugu, Nigeria;
| | - Elias O Agwubike
- Department of Health, Environmental Education and Human Kinetics, University of Benin, Benin City, Nigeria
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