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Briggs Early K, Valencia SI, Stendell-Hollis N, Klyve D, Gee DL. Hypertension Prevalence and Related Risk Factors Among Mexican American Adults Are Increasing: National Health and Nutrition Examination Survey 1999 to 2018. J Am Heart Assoc 2024; 13:e030126. [PMID: 38818945 DOI: 10.1161/jaha.123.030126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 04/15/2024] [Indexed: 06/01/2024]
Abstract
BACKGROUND Acculturation affects hypertension prevalence among Hispanic people, but there have been no recent analyses specifically focused on Mexican American (MA) people. We sought to determine age-adjusted hypertension prevalence, abdominal obesity, and acculturation trends among MA adults and non-Hispanic White adults. METHODS AND RESULTS Data from the NHANES (National Health and Nutrition Examination Survey) were analyzed in 2-year increments to observe trends in hypertension and risk factors (age, sex, body mass index, smoking status, abdominal obesity, waist-to-height ratio (WHtR), education, and income). Acculturation was based on three commonly used measures. The sample included 30 920 adults. Age-adjusted hypertension prevalence is higher in MA adults (52.7%) than White adults (48.3%). Hypertension risk factors-age, obesity prevalence, WHtR, acculturation-all significantly increased among MA adults, while smoking declined. Higher acculturation scores increased hypertension likelihood (odds ratio [OR], 1.44 [95% CI, 0.91-1.97]) for MA adults compared with those with lower acculturation scores. White adults with elevated WHtR >0.5 had a 40% higher risk of hypertension than those with WHtR <0.5, but among MA adults, elevated WHtR did not increase risk for hypertension. There was a significant increase in hypertension prevalence among MA adults from 2003 to 2018 at an average biennial rate of 2.23%. There was no change in hypertension prevalence among White adults from 1999 to 2018. CONCLUSIONS Over 20 years of NHANES, more highly acculturated MA adults were at greater risk for hypertension, despite declines in smoking and controlling for age, sex, obesity status, education, and income. Finding ways to promote more traditional lifestyle and eating habits for MA adults could be a beneficial approach to reducing hypertension risk factors in this population.
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Affiliation(s)
- Kathaleen Briggs Early
- Department of Biomedical Sciences Pacific Northwest University of Health Sciences Yakima WA USA
| | - Sandra I Valencia
- Department of Health Sciences Central Washington University Ellensburg WA USA
| | | | - Dominic Klyve
- Department of Mathematics Central Washington University Ellensburg WA USA
| | - David L Gee
- Department of Health Sciences Central Washington University Ellensburg WA USA
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Palacios N, Gordon S, Wang T, Burk R, Qi Q, Huttenhower C, Gonzalez HM, Knight R, De Carli C, Daviglus M, Lamar M, Telavera G, Tarraf W, Kosciolek T, Cai J, Kaplan RC. Gut Microbiome Multi-Omics and Cognitive Function in the Hispanic Community Health Study/Study of Latinos- Investigation of Neurocognitive Aging. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.05.17.24307533. [PMID: 38798527 PMCID: PMC11118626 DOI: 10.1101/2024.05.17.24307533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
INTRODUCTION We conducted a study within the Hispanic Community Health Study/Study of Latinos- Investigation of Neurocognitive Aging (HCHS/SOL-INCA) cohort to examine the association between gut microbiome and cognitive function. METHODS We analyzed the fecal metagenomes of 2,471 HCHS/SOL-INCA participants to, cross-sectionally, identify microbial taxonomic and functional features associated with global cognitive function. Omnibus (PERMANOVA) and feature-wise analyses (MaAsLin2) were conducted to identify microbiome-cognition associations, and specific microbial species and pathways (Kyoto Encyclopedia of Genes and Genomes (KEGG modules) associated with cognition. RESULTS Eubacterium species( E. siraeum and E. eligens ), were associated with better cognition. Several KEGG modules, most strongly Ornithine, Serine biosynthesis and Urea Cycle, were associated with worse cognition. DISCUSSION In a large Hispanic/Latino cohort, we identified several microbial taxa and KEGG pathways associated with cognition.
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Persky V, Abasilim C, Tsintsifas K, Day T, Sargis RM, Daviglus M, Cai J, Freels S, Kaplan R, Isasi CR, Pirzada A, Meyer ML, Talavera GA, Thyagarajan B, Agarwal S, Chavez N, Grieco A, Turyk ME. Thyroid Hormones and Diabetes in Euthyroid Hispanic/Latino Adults of Diverse Backgrounds: HCHS/SOL. J Endocr Soc 2024; 8:bvae039. [PMID: 38623380 PMCID: PMC11017329 DOI: 10.1210/jendso/bvae039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Indexed: 04/17/2024] Open
Abstract
Context Previous studies have demonstrated associations of endogenous thyroid hormones with diabetes; less is known about stages of diabetes development at which they are operative, mechanisms of associations, and the role of the hypothalamic-pituitary-thyroid axis. Objective This study examined associations of thyroid hormones with incident prediabetes and diabetes and with changes in glycemic traits in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), the largest cohort of Hispanic/Latino adults with diverse backgrounds in the United States. Methods The study includes 592 postmenopausal euthyroid women and 868 euthyroid men aged 45 to 74 years without diabetes at baseline participating in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Baseline hormones included thyrotropin (TSH), free thyroxine (FT4), total triiodothyronine (T3), and indices calculated from thyroid hormones evaluating pituitary sensitivity to thyroid hormone. Transitions to diabetes and prediabetes, and changes in glycemic traits determined at the 6-year follow-up visit, were examined using multivariable Poisson and linear regressions. Results Among women, T3 (incident rate ratio [IRR] = 1.65; 95% CI, 1.22-2.24; P = .001) and TSH (IRR = 2.09; 95% CI, 1.01-4.33; P = .047) were positively, while FT4 (IRR = 0.59; 95% CI, 0.39-0.88; P = .011) was inversely, associated with transition from prediabetes to diabetes. Among men, the T3/FT4 ratio was positively associated with transition from normoglycemia to prediabetes but not from prediabetes to diabetes. Indices measuring sensitivity of the pituitary to thyroid hormone suggested increased sensitivity in men who transitioned from prediabetes to diabetes. Conclusion Positive associations in women of T3 and TSH and inverse associations of FT4, as well as inverse associations of thyroid indices in men with transition from prediabetes to diabetes, but not from normoglycemia to diabetes, suggest decreased pituitary sensitivity to thyroid hormones in women and increased sensitivity in men later in the development of diabetes.
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Affiliation(s)
- Victoria Persky
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois Chicago, Chicago, IL 60612, USA
| | - Chibuzor Abasilim
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois Chicago, Chicago, IL 60612, USA
| | - Konstantina Tsintsifas
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois Chicago, Chicago, IL 60612, USA
| | - Tessa Day
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois Chicago, Chicago, IL 60612, USA
| | - Robert M Sargis
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, University of Illinois Chicago and Medical Service, Jesse Brown VA Medical Center, Chicago, IL 60612, USA
| | - Martha Daviglus
- Institute for Minority Health Research, University of Illinois Chicago, Chicago, IL 60612, USA
| | - Jianwen Cai
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Sally Freels
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois Chicago, Chicago, IL 60612, USA
| | - Robert Kaplan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA
- Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, WA 98109, USA
| | - Carmen R Isasi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Amber Pirzada
- Institute for Minority Health Research, University of Illinois Chicago, Chicago, IL 60612, USA
| | - Michelle L Meyer
- Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Gregory A Talavera
- Department of Psychology, San Diego State University, San Diego, CA 92182, USA
| | - Bharat Thyagarajan
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN 55415, USA
| | - Shivani Agarwal
- Fleischer Institute for Diabetes and Metabolism, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY 10461, USA
| | - Noel Chavez
- Division of Community Health Sciences, University of Illinois Chicago, Chicago, IL 60612, USA
| | - Arielle Grieco
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois Chicago, Chicago, IL 60612, USA
| | - Mary E Turyk
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois Chicago, Chicago, IL 60612, USA
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Abasilim C, Persky V, Sargis RM, Argos M, Daviglus M, Freels S, Cai J, Tsintsifas K, Isasi CR, Peters BA, Talavera GA, Thyagarajan B, Turyk ME. Thyroid-related Hormones and Hypertension Incidence in Middle-Aged and Older Hispanic/Latino Adults: The HCHS/SOL Study. J Endocr Soc 2024; 8:bvae088. [PMID: 38741939 PMCID: PMC11088988 DOI: 10.1210/jendso/bvae088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Indexed: 05/16/2024] Open
Abstract
Background Thyroid-related hormones act to regulate metabolic pathways and blood pressure (BP). However, the relationship of TSH and peripheral thyroid hormones and the role of the hypothalamic-pituitary-thyroid axis on hypertension development is not fully understood. We assessed sex-specific associations of thyroid-related hormones with BP and hypertension in Hispanic/Latino adults followed for 6 years. Methods We studied 1789 adults, ages 45 to 74, free of diabetes at baseline from a subcohort of the Hispanic Community Health Study/Study of Latinos. We assessed TSH, free T4 (FT4), T3, and various indicators of thyroid axis. Using multivariable linear and Poisson regression adjusted for survey design and confounding variables, we estimated a priori sex-specific associations of thyroid-related hormones with changes in BP and hypertension development. Results In men and women, TSH and TSH/FT4 ratios were associated with changes in diastolic BP and T3 with changes in pulse pressure and the development of hypertension from prehypertension. In men, a 1-SD increase in TSH [incident rate ratio (IRR) = 1.42; 95% confidence interval (CI): 1.15, 1.75] and TSH/FT4 ratio (IRR = 1.20; 95% CI: 1.07, 1.35) were positively associated with the development of hypertension from prehypertension while the TSH/FT4 ratio (IRR = 0.85; 95% CI: .72, 1.00) was protective in women. We observed sex-specific differences in associations of the T3/FT4 ratio and indices of pituitary sensitivity to thyroid hormones with changes in pulse pressure and hypertension development. Conclusion Thyroid-related hormones are associated with sex-specific changes in BP and hypertension among Hispanic/Latino adults consistent with selected studies conducted in other populations. Mechanisms underlying associations of pituitary sensitivity to thyroid hormones with BP and hypertension development warrant further study.
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Affiliation(s)
- Chibuzor Abasilim
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois Chicago, Chicago, IL 60612, USA
- Division of Environmental and Occupational Health Sciences, School of Public Health, University of Illinois Chicago, Chicago, IL 60612, USA
| | - Victoria Persky
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois Chicago, Chicago, IL 60612, USA
| | - Robert M Sargis
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, University of Illinois Chicago and Medical Service, Jesse Brown VA Medical Center, Chicago, IL 60612, USA
| | - Maria Argos
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois Chicago, Chicago, IL 60612, USA
| | - Martha Daviglus
- Institute for Minority Health Research, University of Illinois Chicago, Chicago, IL 60612, USA
| | - Sally Freels
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois Chicago, Chicago, IL 60612, USA
| | - Jianwen Cai
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Konstantina Tsintsifas
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois Chicago, Chicago, IL 60612, USA
| | - Carmen R Isasi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Brandilyn A Peters
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Gregory A Talavera
- Department of Psychology, San Diego State University, San Diego, CA 92182, USA
| | - Bharat Thyagarajan
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN 55415, USA
| | - Mary E Turyk
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois Chicago, Chicago, IL 60612, USA
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Fouotsa NCM, Ndjaboue R, Ngueta G. Race/Ethnicity and Other Predictors of Early-Onset Type 2 Diabetes Mellitus in the US Population. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-01980-8. [PMID: 38512423 DOI: 10.1007/s40615-024-01980-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 03/06/2024] [Accepted: 03/13/2024] [Indexed: 03/23/2024]
Abstract
OBJECTIVES Among US adults aged 20 + years in the USA with previously diagnosed type 2 diabetes mellitus (T2DM), we aimed to estimate the prevalence of early-onset T2DM (onset at age < 50.5 years) and to test associations between early-onset T2DM and race/ethnicity, and other hypothesized predictors. METHODS We pooled data from the annual National Health and Nutrition Examination Surveys (NHANES) over the years 2001 through 2018. We tested hypotheses of association and identified predictors using stepwise logistic regression analysis, and 11 supervised machine learning classification algorithms. RESULTS After appropriate weighting, we estimated that among adults in the USA aged 20 + years with previously diagnosed T2DM, the prevalence of early-onset was 52.9% (95% confidence intervals, 49.6 to 56.2%). Among Non-Hispanic Whites (NHW) the prevalence was 48.6% (95% CI, 44.6 to 52.6%), among Non-Hispanic Blacks: 56.9% (95% CI, 51.8 to 62.0%), among Hispanics: 62.7% (95% CI, 53.2 to 72.3%). In the final multivariable logistic regression model, the top-3 markers predicting early-onset T2DM in males were NHB ethnicity (OR = 2.97; 95% CI: 2.24-3.95) > tobacco smoking (OR = 2.79; 95% CI: 2.18-3.58) > high education level (OR = 1.65; 95% CI: 1.27-2.14) in males. In females, the ranking was tobacco smoking (OR = 2.59; 95% CI: 1.90-3.53) > Hispanic ethnicity (OR = 1.49; 95% CI: 1.08-2.05) > obesity (OR = 1.30; 95% CI: 0.91-1.86) in females. The acculturation score emerged from the machine learning approach as the dominant marker explaining the race disparity in early-onset T2DM. CONCLUSIONS The prevalence of early-onset T2DM was higher among NHB and Hispanic people, than among NHW people. Independently of race/ethnicity, acculturation, tobacco smoking, education level, marital status, obesity, and hypertension were also predictive.
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Affiliation(s)
- Noé Carème Manfouo Fouotsa
- CHU de Sherbrooke Research Center, DOCC (Diabetes, Obesity and Cardiovasvascular Complications), CRCHUS-Hôpital Fleurimont, 12Eme Avenue Nord, Sherbrooke, Québec, 3001, Canada
| | - Ruth Ndjaboue
- Canada Research Chair in Inclusivity and Active Ageing, University of Sherbrooke, Sherbrooke, Canada
- Research Centre on Aging, University of Sherbrooke, Sherbrooke, Canada
| | - Gerard Ngueta
- CHU de Sherbrooke Research Center, DOCC (Diabetes, Obesity and Cardiovasvascular Complications), CRCHUS-Hôpital Fleurimont, 12Eme Avenue Nord, Sherbrooke, Québec, 3001, Canada.
- Department of Community Health Sciences, Faculty of Medicine & Health Sciences, Université de Sherbrooke, Sherbrooke, Québec, Canada.
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Yang E, Heckbert SR, Ding J, Spragg D, Calkins H, Shah S, Szklo M, Post WS, Sharma K. Prevalence of Subclinical Atrial Fibrillation in Heart Failure With Preserved Ejection Fraction. JACC. HEART FAILURE 2024; 12:492-504. [PMID: 37999661 DOI: 10.1016/j.jchf.2023.09.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 09/25/2023] [Accepted: 09/26/2023] [Indexed: 11/25/2023]
Abstract
BACKGROUND Atrial fibrillation (AF) is common in patients with heart failure with preserved ejection fraction (HFpEF) and is associated with poorer clinical outcomes. The prevalence of subclinical AF in patients with HFpEF remains unknown. OBJECTIVES The aim of this study was to determine whether subclinical AF was more prevalent in individuals with HFpEF than in individuals without histories of heart failure (HF). METHODS Patients with HFpEF with no prior diagnoses of AF were screened for subclinical AF, and the prevalence of subclinical AF was compared with that among control subjects without HF drawn from MESA (Multi-Ethnic Study of Atherosclerosis) who underwent the same electrocardiographic monitoring. Multivariable logistic regression was used to adjust for demographic and clinical comorbidities. RESULTS Ninety patients with HFpEF and 1,230 MESA participants were included. Patients with HFpEF were younger (median age 69 years [Q1-Q3: 63-76 years] vs 72 years [Q1-Q3: 66-80 years]; P = 0.02), more obese (median body mass index 36 kg/m2 [Q1-Q3: 30-45 kg/m2] vs 27 kg/m2 [Q1-Q3: 24-30 kg/m2]; P < 0.001), and more likely to have diabetes (34% vs 21%; P = 0.01). The prevalence of subclinical AF was 8.9% in patients with HFpEF and 4.1% in non-HF participants. After multivariable adjustment for age, sex, race, body mass index, diabetes, smoking, and total analyzable time on electrocardiographic monitor, there was a significantly higher odds of subclinical AF in patients with HFpEF compared with MESA (OR: 3.01; 95% CI: 1.13-7.99; P = 0.03). CONCLUSIONS Patients with HFpEF had a higher prevalence of subclinical AF than participants without HF from a community-based study. Screening for atrial arrhythmias may be appropriate among patients with HFpEF for timely initiation of thromboembolic prophylaxis and may identify individuals at greater risk for clinical decompensation.
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Affiliation(s)
- Eunice Yang
- Inova Schar Heart and Vascular Institute, Fairfax, Virginia, USA; Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Susan R Heckbert
- University of Washington School of Medicine, Seattle, Washington, USA
| | - Jennifer Ding
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - David Spragg
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Hugh Calkins
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Sanjiv Shah
- Northwestern University School of Medicine, Chicago, Illinois, USA
| | - Moyses Szklo
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Wendy S Post
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Kavita Sharma
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
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Luo T, Beiter K, Tseng TS. Association between acculturation, dental floss use, dental visits and unmet dental needs among Asians in the United States: Findings from National Health and Nutrition Examination Survey (NHANES) 2011-2018. Community Dent Oral Epidemiol 2024; 52:101-110. [PMID: 37646317 DOI: 10.1111/cdoe.12906] [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] [Received: 03/01/2023] [Revised: 07/31/2023] [Accepted: 08/20/2023] [Indexed: 09/01/2023]
Abstract
OBJECTIVES The objectives of this study were to examine the associations between acculturation and dental floss, regular dental visits and unmet dental care needs among Asian Americans, as well as the moderating effects of these associations. METHODS This study analysed national representative samples from the National Health and Nutrition Examination Survey (NHANES) 2011-2018. A total of 2763 Asian Americans aged 20 and older were included in this analysis. The primary predictor, acculturation score, was determined by three questions: (i) language spoken at home (higher score for English), (ii) country of birth (higher score for United States) and (iii) length of time in the United States. Dental floss use, dental visits and unmet dental care needs were included as outcomes in this study. Descriptive statistics and logistic regressions were used to analyse the samples. RESULTS Acculturation was significantly associated with dental health behaviours: Individuals with higher levels of acculturation were more likely than less acculturated individuals to use dental floss (81.0% vs. 63.9%, respectively) and visit the dentist regularly (76.7% vs. 66.9% respectively). Insurance status moderated the association between acculturation and dental visits: Acculturation was significantly associated with dental visits in the past year among insured individuals (OR = 1.70, 95% CI: 1.29-2.23), but not among uninsured individuals. Unmet dental care needs were present in 11.1% of participants. While costs and insurance were the top two determinants of access to care, individuals with and without insurance differed with regard to their third major reason for unmet dental care needs: Being 'too busy' and not wanting to spend money on dental care. CONCLUSIONS Among the Asian population in the United States, those with high acculturation scores were more likely to engage in dental flossing and visit the dentist regularly compared to those Asians with lower acculturation scores. To encourage dental flossing and regular dental visits among Asians with lower acculturation scores, cultural adaptation and language accessibility suggests being considered. Future research is necessary to confirm the moderating effect of insurance status on the association between acculturation and regular dental visits. Additionally, our findings emphasize the impact of costs and insurance on access to dental care among Asians in the United States, highlighting the importance of future public health programmes in addressing these barriers.
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Affiliation(s)
- Ting Luo
- Moores Cancer Center, School of Medicine, University of California San Diego, La Jolla, California, USA
| | - Kaylin Beiter
- School of Medicine, Louisiana State University Health Sciences Center-New Orleans, New Orleans, Louisiana, USA
- Behavioral and Community Health Sciences, School of Public Health, Louisiana State University Health Sciences Center-New Orleans, New Orleans, Louisiana, USA
| | - Tung-Sung Tseng
- Behavioral and Community Health Sciences, School of Public Health, Louisiana State University Health Sciences Center-New Orleans, New Orleans, Louisiana, USA
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Flórez KR, Hwang NS, Hernandez M, Verdaguer-Johe S, Rahnama Rad K. "No sufro, estoy bien/I am not suffering, so I am doing OK": A mixed method exploration of individual and network-level factors and Type 2 Diabetes Mellitus (T2DM) among Mexican American adults in New York City. PLoS One 2024; 19:e0295499. [PMID: 38241426 PMCID: PMC10798639 DOI: 10.1371/journal.pone.0295499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 11/24/2023] [Indexed: 01/21/2024] Open
Abstract
INTRODUCTION The prevalence of type 2 Diabetes Mellitus (T2DM) is 2-3 times greater among Mexican Americans than non-Latino whites, and Mexican Americans are more likely to develop T2DM at younger ages and experience higher rates of complications. Social networks might play a crucial role in both T2DM etiology and management through social support, access to resources, social engagement, and health behavioral norms. OBJECTIVE To quantitatively identify the social network features associated with glycated hemoglobin (HbA1c) in a community sample of Mexican immigrants residing in New York City, and to explore the extent to which these quantitative findings converge with qualitative narratives of their lived experiences. METHODS This study used a convergent mixed methods design. To collect personal network data, we used EgoWeb, and obtained 1,400 personal network ties from 81 participants. HbA1c readings were collected using dried blood spots and categorized according to the laboratory criteria of the American Diabetes Association. Additional survey data were collected using Qualtrics software. To investigate the significance of the network-level factors after accounting for the socioeconomic and demographic individual-level factors that the literature indicates to be associated with T2DM, we used a multiple regression model on quantitative data sources. For the qualitative portion of the study, we selected a subset of individuals who participated in the quantitative portion, which represented 500 personal network ties from 25 participants. We conducted in-depth interviews guided by the visualization of these ties to explore who was helpful or difficult in managing their health and health behaviors. RESULTS Individual-level indicators associated with lower HbA1c scores were body mass index (β = -0.07, p<0.05), and healthy eating index scores (β = -0.03, p<0.02). The network-level predictor associated with higher HbA1c levels was the percentage of diabetic alters in the network (β = 0.08, p <0.001, with a 25% increase in the percentages associated 2.0 change in HbA1c levels. The qualitative data highlighted that most of the diabetes-related information diffused through the social networks of our participants was related to dietary practices, such as reducing sugar and red meat consumption, eating out less, and reducing portion sizes. Notably, even among those with elevated levels and diabetes-related health complications, HbA1c was not considered a part of the lay descriptions of good health since they were not "suffering." Participants regarded doctors as the ultimate authority in diabetes care, even if they had supportive members in their personal networks. CONCLUSION Our study provides quantitative evidence for the significant role of diabetic network members in the etiology and management of T2DM among Mexican Americans. Our qualitative findings suggest important ley terms for T2DM management and the importance of physicians, which could be included in in future social networks studies seeking to diffuse diabetes-related health information for T2DM prevention and management efforts in this population.
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Affiliation(s)
- Karen R. Flórez
- Environmental, Occupational and Geospatial Sciences Department, City University of New York (CUNY), CUNY Graduate School of Public Health and Heath Policy, New York, NY, United States of America
- Center for Systems and Community Design, City University of New York (CUNY), CUNY Graduate School of Public Health and Heath Policy, New York, NY, United States of America
| | - Neil S. Hwang
- Business and Information Systems Department, City University of New York, Bronx Community College, Bronx, NY, United States of America
| | - Maria Hernandez
- El Instituto: Institute of Latina/o, Caribbean and Latin America Studies of College of Liberal Arts and Science, University of Connecticut, Storrs, CT, United States of America
| | - Sandra Verdaguer-Johe
- Department of Community Health and Social Sciences, CUNY Graduate School of Public Health and Health Policy, New York, NY, United States of America
| | - Kamiar Rahnama Rad
- Paul H. Chook Department of Information Systems and Statistics, City University of New York, Zicklin School of Business Baruch College, New York, NY, United States of America
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Zhang Y, Chen GC, Sotres-Alvarez D, Perreira KM, Daviglus ML, Pirzada A, Gallo LC, Llabre MM, Cai J, Xue X, Isasi CR, Kaplan R, Qi Q. General or Central Obesity and Mortality Among US Hispanic and Latino Adults. JAMA Netw Open 2024; 7:e2351070. [PMID: 38227314 PMCID: PMC10792478 DOI: 10.1001/jamanetworkopen.2023.51070] [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: 08/28/2023] [Accepted: 11/01/2023] [Indexed: 01/17/2024] Open
Abstract
Importance The Hispanic and Latino population is the second largest ethnic group in the US, but associations of obesity parameters with mortality in this population remain unclear. Objective To investigate the associations of general and central obesity with mortality among US Hispanic and Latino adults. Design, Setting, and Participants The Hispanic Community Health Study/Study of Latinos is an ongoing, multicenter, population-based cohort study with a multistage probability sampling method performed in Hispanic and Latino adults aged 18 to 74 years with a baseline between January 1, 2008, and December 31, 2011. Active follow-up for this analyses extended from baseline through February 17, 2022. All analyses accounted for complex survey design (ie, stratification and clustering) and sampling weights to generate estimates representing the noninstitutionalized, 18- to 74-year-old Hispanic or Latino populations from selected communities. Exposures Body mass index (BMI; calculated as weight in kilograms divided by height in meters squared), body fat percentage, waist circumference (WC), and waist to hip ratio (WHR). Main Outcome and Measure Deaths were ascertained via death certificates, the National Death Index, and active follow-up. Results Of 15 773 adults (mean [SE] age, 40.9 [0.3] years; 52.8% female), 686 deaths occurred during a median (IQR) follow-up of 10.0 (9.9-10.2) years. When adjusting for sociodemographic, lifestyle, and family history covariates, hazard ratios (HRs) for mortality were 1.55 (95% CI, 1.08-2.22) for a BMI of 35.0 or greater vs 18.5 to 24.9, 1.22 (95% CI, 0.92-1.64) for the highest vs lowest body fat percentage groups (defined according to sex-, age-, and Hispanic or Latino background-specific BMI distribution), 1.35 (95% CI, 0.98-1.85) for WC greater than 102 cm (men) or 88 cm (women) vs 94 cm (men) or 80 cm (women) or less, and 1.91 (95% CI, 1.28-2.86) for WHR of 0.90 (men) or 0.85 (women) or greater vs less than 0.90 (men) or 0.85 (women). Only WHR was associated with mortality with additional adjustment for major comorbidities (HR, 1.75; 95% CI, 1.17-2.62). The association of WHR with mortality was stronger among women compared with men (P = .03 for interaction), and the association between BMI and mortality was stronger among men (P = .02 for interaction). The positive association between severe obesity (BMI ≥ 35.0) and mortality was observed only among adults with WHR of 0.90 (men) or 0.85 (women) or greater but not among those with WHR below 0.90 (men) or 0.85 (women) (P = .005 for interaction) who had greater hip circumference. Conclusions and Relevance In this cohort of US Hispanic and Latino adults, WHR was independently associated with higher all-cause mortality regardless of BMI and prevalent comorbidities. These findings suggest that prioritizing clinical screening and intervention for WHR in this population may be an important public health strategy, with sex-specific strategies potentially being needed.
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Affiliation(s)
- Yanbo Zhang
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Guo-Chong Chen
- Department of Nutrition and Food Hygiene, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Daniela Sotres-Alvarez
- Department of Biostatistics, Gillings School of Global Public Health, Chapel Hill, North Carolina
| | - Krista M. Perreira
- Department of Social Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill
| | | | - Amber Pirzada
- Institute for Minority Health Research, University of Illinois, Chicago
| | - Linda C. Gallo
- Department of Psychology, San Diego State University, San Diego, California
| | - Maria M. Llabre
- Department of Psychology, University of Miami, Miami, Florida
| | - Jianwen Cai
- Department of Biostatistics, Gillings School of Global Public Health, Chapel Hill, North Carolina
| | - Xiaonan Xue
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Carmen R. Isasi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Robert Kaplan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Qibin Qi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
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10
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Lemdjo G, Kengne AP, Nouthe B, Lucas M, Carpentier A, Ngueta G. Humero-femoral index and diabetes risk in the US population- a case study. J Diabetes Metab Disord 2023; 22:1327-1335. [PMID: 37975100 PMCID: PMC10638166 DOI: 10.1007/s40200-023-01251-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 06/13/2023] [Indexed: 11/18/2023]
Abstract
Background The between-subject variability in diabetes risk persists in epidemiological studies, even after accounting for obesity. We investigated whether the humero-femoral index (HFI) was associated with prevalence of type 2 diabetes mellitus (T2DM) and assessed the incremental value of HFI as a marker of T2DM. Methods This population-based cross-sectional study used data from the National Health and Nutrition Examination Survey from 1999 to 2018. We assessed 42,088 adults aged ≥ 30 years. HFI was defined as the upper arm length/upper leg length ratio. The outcome included undiagnosed diabetes (based on 2-hour plasma glucose levels, fasting glucose and hemoglobin A1C) and history of diabetes (diagnosed diabetes or taking antidiabetic drugs). Results As compared with the bottom quartile, the prevalence ratio of T2DM was 1.28 (95% CI 1.19-1.38) in the second, 1.61 (95% CI 1.50-1.72) in the third, and 1.75 (95% CI 1.64-1.88) in the fourth quartile of HFI (P for trend < 0.0001). The positive association remained consistent within different patterns of BMI and WC in men but was rendered null in women. After adding HFI to the reference model (including WC only), the discrimination slopes increased by 60.0% in men and 51.1% in women. Conclusion Our findings suggest that HFI may be a key component in body structure contributing to the risk of T2DM. In men, the highest HFI was associated with elevated prevalence of T2DM, independent of BMI and WC. Supplementary Information The online version contains supplementary material available at 10.1007/s40200-023-01251-z.
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Affiliation(s)
- Gaelle Lemdjo
- Endocrinology Unit, Jordan Medical Service, Yaounde, Cameroon
| | - André Pascal Kengne
- Non-Communicable Disease Research Unit, South African Medical Research Council, Cape Town, South Africa
- Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Brice Nouthe
- Fraser Health Authority/Department of Medicine, University of British Columbia, Vancouver, Canada
| | - Michel Lucas
- Department of Social and Preventive Medicine, Faculty of medicine, Laval University, Québec, Canada
| | - André Carpentier
- Division of Endocrinology, Department of Medicine, University of Sherbrooke, Sherbrooke, Canada
- Research Center of the CHU de Sherbrooke, University of Sherbrooke, Sherbrooke, Québec Canada
| | - Gérard Ngueta
- Research Center of the CHU de Sherbrooke, University of Sherbrooke, Sherbrooke, Québec Canada
- Department of Community Health Sciences, University of Sherbrooke, Sherbrooke, Québec Canada
- Centre de recherche du CHU de Sherbrooke, CRCHUS- Hôpital Fleurimont, Axe: Diabète, Obésité, Complications cardiovasculaires), Service d’endocrinologie, 12 eme Avenue Nord, Sherbrooke, 3001 Canada
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11
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Senn MK, Goodarzi MO, Ramesh G, Allison MA, Graff M, Young KL, Talavera GA, McClain AC, Garcia TP, Rotter JI, Wood AC. Associations between avocado intake and measures of glucose and insulin homeostasis in Hispanic individuals with and without type 2 diabetes: Results from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Nutr Metab Cardiovasc Dis 2023; 33:2428-2439. [PMID: 37798236 PMCID: PMC10842938 DOI: 10.1016/j.numecd.2023.08.002] [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: 04/16/2023] [Revised: 07/27/2023] [Accepted: 08/01/2023] [Indexed: 10/07/2023]
Abstract
BACKGROUND AND AIMS To investigate associations between avocado intake and glycemia in adults with Hispanic/Latino ancestry. METHODS AND RESULTS The associations of avocado intake with measures of insulin and glucose homeostasis were evaluated in a cross-sectional analysis of up to 14,591 Hispanic/Latino adults, using measures of: average glucose levels (hemoglobin A1c; HbA1c), fasting glucose and insulin, glucose and insulin levels after an oral glucose tolerance test (OGTT), and calculated measures of insulin resistance (HOMA-IR, and HOMA-%β), and insulinogenic index. Associations were assessed using multivariable linear regression models, which controlled for sociodemographic factors and health behaviors, and which were stratified by dysglycemia status. In those with normoglycemia, avocado intake was associated with a higher insulinogenic index (β = 0.17 ± 0.07, P = 0.02). In those with T2D (treated and untreated), avocado intake was associated with lower hemoglobin A1c (HbA1c; β = -0.36 ± 0.21, P = 0.02), and lower fasting glucose (β = -0.27 ± 0.12, P = 0.02). In the those with untreated T2D, avocado intake was additionally associated with HOMA-%β (β = 0.39 ± 0.19, P = 0.04), higher insulin values 2-h after an oral glucose load (β = 0.62 ± 0.23, P = 0.01), and a higher insulinogenic index (β = 0.42 ± 0.18, P = 0.02). No associations were observed in participants with prediabetes. CONCLUSIONS We observed an association of avocado intake with better glucose/insulin homeostasis, especially in those with T2D.
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Affiliation(s)
- MacKenzie K Senn
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, 1100 Bates Avenue Houston, TX 77030, USA; The University of Texas Health Science Center at Houston School of Public Health, 1200 Pressler Street, Houston, TX 77030, USA
| | - Mark O Goodarzi
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Gautam Ramesh
- School of Medicine, University of California, La Jolla, San Diego, CA 92037, USA
| | - Matthew A Allison
- Division of Preventive Medicine, Department of Family Medicine, University of California, La Jolla, San Diego, CA 92037, USA
| | - Mariaelisa Graff
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Kristin L Young
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Gregory A Talavera
- Department of Psychology, San Diego State University, San Diego, CA 92182, USA
| | - Amanda C McClain
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA 92182, USA
| | - Tanya P Garcia
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Jerome I Rotter
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Alexis C Wood
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, 1100 Bates Avenue Houston, TX 77030, USA.
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12
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ZHAO BEIBO, SOTRES-ALVAREZ DANIELA, EVENSON KELLYR, GREENLEE HEATHER, MOSSAVAR-RAHMANI YASMIN, QI QIBIN, MARQUEZ DAVIDX, VIDOT DENISEC, ELFASSY TALI, ARREDONDO ELVAM, DIAZ KEITHM. Day-of-the-Week and Time-of-the-Day Patterns of Sedentary Behavior in the Hispanic Community Health Study/Study of Latinos. Med Sci Sports Exerc 2023; 55:2203-2213. [PMID: 37494828 PMCID: PMC10662624 DOI: 10.1249/mss.0000000000003266] [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] [Indexed: 07/28/2023]
Abstract
PURPOSE Existing sedentary behavior interventions have largely achieved mixed results. Conventionally, interventions have attempted to reduce sedentary behavior using a full-day approach. An alternative strategy may be to target specific periods during the day and/or week. This study examined the day-of-the-week (Monday to Sunday) and time-of-the-day patterns (3-and 6-h periods) of sedentary behavior among U.S. Hispanics/Latinos adults. METHODS Participants ( n = 12,241) from the Hispanic Community Health Study/Study of Latinos, a multisite community-based prospective cohort study of Hispanic/Latino adults, were studied. Sedentary behavior was assessed for 1 wk using a hip-mounted accelerometer through total sedentary time, sedentary time in bouts ≥60 min, and total number of sedentary breaks. The temporal patterns of sedentary behavior metrics were evaluated using linear mixed effect models accounting for the Hispanic Community Health Study/Study of Latinos complex survey design. RESULTS There were statistically significant variations in temporal patterns across day-of-the-week and time-of-the-day periods for all three metrics ( P < 0.001). Adults were more sedentary on weekends than on weekdays and most sedentary on Sundays. The time-of-the-day patterns had a U-curve pattern wherein adults were most sedentary late at night, became less sedentary throughout the day, reached peak activeness around noon, then gradually became more sedentary into the evening. These patterns were largely robust across seasonality and most sociodemographic characteristics, including age, employment status, work shift schedule, acculturation, and field center. CONCLUSIONS Our findings suggest that early mornings, evenings, and weekends were the more sedentary periods in this cohort of Hispanic/Latino adults, characterized by higher volumes of sedentary time, higher volumes of time in prolonged sedentary bouts, and fewer number of sedentary breaks than other time periods, highlighting important windows of opportunity to reduce sedentary behavior.
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Affiliation(s)
- BEIBO ZHAO
- Department of Biostatistics, University of North Carolina, Chapel Hill, NC
| | | | - KELLY R. EVENSON
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
| | | | - YASMIN MOSSAVAR-RAHMANI
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - QIBIN QI
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - DAVID X. MARQUEZ
- Department of Kinesiology and Nutrition, University of Illinois Chicago, Chicago, IL
| | - DENISE C. VIDOT
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL
| | - TALI ELFASSY
- Department of Medicine, Miller School of Medicine, University of Miami, Coral Gables, FL
| | | | - KEITH M. DIAZ
- Center for Behavioral Cardiovascular Health, Columbia University Medical Center, New York, NY
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13
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Abasilim C, Persky V, Sargis RM, Argos M, Daviglus ML, Freels S, Tsintsifas K, Day T, Cai J, Isasi CR, Peters BA, Talavera GA, Thyagarajan B, Turyk ME. Association of Acculturation and Hispanic/Latino Background with Endogenous Sex and Thyroid-Related Hormones Among Middle-Aged and Older Hispanic/Latino Adults: the HCHS/SOL Study. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01762-8. [PMID: 37620727 DOI: 10.1007/s40615-023-01762-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 08/11/2023] [Accepted: 08/14/2023] [Indexed: 08/26/2023]
Abstract
BACKGROUND Hormones are linked to cardiometabolic diseases and may be impacted by acculturation though multiple mechanisms. We evaluated associations of Hispanic/Latino background and acculturation with levels of sex- and thyroid-related hormones and the potential mediating effect of adiposity, lifestyle factors, and sleep apnea syndrome on these associations. METHODS We studied 1789 adults, aged 45-74, from a sub-cohort of the Hispanic Community Health Survey/Study of Latinos. Peri/pre-menopausal women and individuals on medications related to hormones were excluded. Our study assessed eleven sex- and thyroid-related hormones, Hispanic/Latino background, and five acculturation measures. Associations were assessed using multivariable linear and logistic regression adjusted for survey design and confounding variables. We explored potential mediation using a path analysis. RESULTS In postmenopausal women, acculturation score-MESA was associated with decreased thyroid-stimulating hormone (β = - 0.13;95%CI = - 0.22, - 0.03) while age at immigration greater than the median (vs US-born) was associated with decreased (β = - 14.6; 95%CI = - 28.2, - 0.99) triiodothyronine (T3). In men, language acculturation and acculturation score-MESA were associated with increased estradiol and sex hormone-binding globulin (SHBG) while age at immigration greater and lesser than the median (vs US-born) was associated with decreased SHBG. Hispanic/Latino background (Mexicans as reference) were selectively associated with sex- and thyroid-related hormone levels in both sexes. Current smoking and sleep apnea syndrome partially mediated the association of Cuban and Puerto Rican heritage (vs Mexican) with T3 levels in men and postmenopausal women, respectively. CONCLUSION Selected acculturation measures were associated with thyroid-related hormones in postmenopausal women and sex-related hormones in men. Understanding the mechanisms involved in the relationship of acculturation and Hispanic/Latino background with hormones warrants additional investigation.
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Affiliation(s)
- Chibuzor Abasilim
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois Chicago, Chicago, IL, USA.
- Division of Environmental and Occupational Health Sciences, School of Public Health, University of Illinois Chicago, Chicago, IL, USA.
| | - Victoria Persky
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois Chicago, Chicago, IL, USA
| | - Robert M Sargis
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, University of Illinois Chicago and Medical Service, Jesse Brown VA Medical Center, Chicago, IL, USA
| | - Maria Argos
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois Chicago, Chicago, IL, USA
| | - Martha L Daviglus
- Institute for Minority Health Research, University of Illinois Chicago, Chicago, IL, USA
| | - Sally Freels
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois Chicago, Chicago, IL, USA
| | - Konstantina Tsintsifas
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois Chicago, Chicago, IL, USA
| | - Tessa Day
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois Chicago, Chicago, IL, USA
| | - Jianwen Cai
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Carmen R Isasi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Brandilyn A Peters
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Gregory A Talavera
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Bharat Thyagarajan
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA
| | - Mary E Turyk
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois Chicago, Chicago, IL, USA
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14
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Noah AI, Perez-Patron MJ, Gongalla M, Hill AV, Taylor BD. Foreign-born status and risk of gestational diabetes mellitus by years of residence in the United States. Sci Rep 2023; 13:10060. [PMID: 37344555 DOI: 10.1038/s41598-023-36789-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 06/09/2023] [Indexed: 06/23/2023] Open
Abstract
To explore the association between acculturation among foreign-born (FB) women, gestational diabetes (GDM) and GDM-associated adverse birth outcomes, we conducted a retrospective cohort study of 34,696 singleton pregnancies from Houston, TX, between 2011 and 2022. FB women (n = 18,472) were categorized based on years of residence in US (0-5, 6-10, and > 10 years), while US-born women (n = 16,224) were the reference group. A modified Poisson regression model determined the association between acculturative level and GDM within the entire cohort and stratified by race/ethnicity. Compared to US-born women, FB women with 0-5 years [adjusted relative risk (RRadj.) 1.27, 95% confidence interval [CI] 1.14-1.42)], 6-10 years (RRadj. 1.89, 95%CI 1.68-2.11) and > 10 years in the US (RRadj. 1.85, 95%CI 1.69-2.03) had higher risk of GDM. Results were consistent for all racial/ethnic groups, although associations were not significant at 0-5 years. FB women had lower risk of other adverse pregnancy outcomes, except for preeclampsia with severe features at higher levels of acculturation. Results were similar among those with and without GDM. In conclusion, FB status increases risk of GDM among all racial/ethnic groups but is elevated with higher acculturation levels.
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Affiliation(s)
- Akaninyene I Noah
- Division of Basic Science and Translational Research, Department of Obstetrics and Gynecology, University of Texas Medical Branch, MRB, 11.158A, 301 University Blvd, Galveston, TX, 77555, USA
| | - Maria J Perez-Patron
- Department of Epidemiology and Biostatistics, School of Public Health, Texas A&M University, College Station, TX, USA
| | - Megha Gongalla
- Department of Sociology, College of Liberal Arts, Temple University, Philadelphia, PA, USA
| | - Ashley V Hill
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, USA
| | - Brandie DePaoli Taylor
- Division of Basic Science and Translational Research, Department of Obstetrics and Gynecology, University of Texas Medical Branch, MRB, 11.158A, 301 University Blvd, Galveston, TX, 77555, USA.
- Department of Population Health and Health Disparities, University of Texas Medical Branch, Galveston, TX, USA.
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15
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Persky V, Abasilim C, Tsintsifas K, Day T, Sargis RM, Daviglus ML, Cai J, Freels S, Unterman T, Chavez N, Kaplan R, Isasi CR, Pirzada A, Meyer ML, Talavera GA, Thyagarajan B, Peters BA, Madrigal JM, Grieco A, Turyk ME. Sex Hormones and Diabetes in 45- to 74-year-old Men and Postmenopausal Women: The Hispanic Community Health Study. J Clin Endocrinol Metab 2023; 108:1709-1726. [PMID: 36633580 PMCID: PMC10271226 DOI: 10.1210/clinem/dgad018] [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: 08/19/2022] [Revised: 12/14/2022] [Accepted: 01/06/2023] [Indexed: 01/13/2023]
Abstract
Previous studies demonstrated associations of endogenous sex hormones with diabetes. Less is known about their dynamic relationship with diabetes progression through different stages of the disease, independence of associations, and role of the hypothalamic-pituitary gonadal axis. The purpose of this analysis was to examine relationships of endogenous sex hormones with incident diabetes, prediabetes, and diabetes traits in 693 postmenopausal women and 1015 men aged 45 to 74 years without diabetes at baseline participating in the Hispanic Community Health Study/Study of Latinos and followed for 6 years. Baseline hormones included estradiol, luteinizing hormone (LH), follicle stimulating hormone (FSH), sex hormone-binding globulin (SHBG), dehydroepiandrosterone sulfate (DHEAS), and, in men, testosterone and bioavailable testosterone. Associations were analyzed using multivariable Poisson and linear regressions. In men, testosterone was inversely associated with conversion from prediabetes to diabetes (incidence rate ratio [IRR] for 1 SD increase in testosterone: 0.821; 95% CI, 0.676, 0.997; P = 0.046), but not conversion from normoglycemia to prediabetes. Estradiol was positively associated with increase in fasting insulin and homeostatic model assessment of insulin resistance. In women, SHBG was inversely associated with change in glycosylated hemoglobin, postload glucose, and conversion from prediabetes to diabetes (IRR = 0.62; 95% CI, 0.44, 0.86, P = 0.005) but not from normoglycemia to prediabetes. Relationships with other hormones varied across glycemic measures. Stronger associations of testosterone and SHBG with transition from prediabetes to diabetes than from normoglycemic to prediabetes suggest they are operative at later stages of diabetes development. Biologic pathways by which sex hormones affect glucose homeostasis await future studies.
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Affiliation(s)
- Victoria Persky
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois Chicago, Chicago, IL,USA
| | - Chibuzor Abasilim
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois Chicago, Chicago, IL,USA
| | - Konstantina Tsintsifas
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois Chicago, Chicago, IL,USA
| | - Tessa Day
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois Chicago, Chicago, IL,USA
| | - Robert M Sargis
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Illinois Chicago and Medical Service, Jesse Brown VA Medical Center, Chicago, IL,USA
| | - Martha L Daviglus
- Institute for Minority Health Research, University of Illinois Chicago, Chicago, IL,USA
| | - Jianwen Cai
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC,USA
| | - Sally Freels
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois Chicago, Chicago, IL,USA
| | - Terry Unterman
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Illinois Chicago and Medical Service, Jesse Brown VA Medical Center, Chicago, IL,USA
| | - Noel Chavez
- Division of Community Health Sciences, School of Public Health, University of Illinois Chicago, Chicago, IL,USA
| | - Robert Kaplan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
- Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Carmen R Isasi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Amber Pirzada
- Institute for Minority Health Research, University of Illinois Chicago, Chicago, IL,USA
| | - Michelle L Meyer
- Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC,USA
| | | | - Bharat Thyagarajan
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA
| | - Brandilyn A Peters
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Jessica M Madrigal
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois Chicago, Chicago, IL,USA
| | - Arielle Grieco
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois Chicago, Chicago, IL,USA
| | - Mary E Turyk
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois Chicago, Chicago, IL,USA
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16
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Nagao-Sato S, de Davila SA, Baltaci A, Reyes AOP, Reicks M, Linares R, Zhang Y, Choque GAH. Factors Associated with Fathers' Attendance in a Latino Family Obesity Prevention Program. JOURNAL OF HUMAN SCIENCES AND EXTENSION 2023; 11:2. [PMID: 38274858 PMCID: PMC10810162 DOI: 10.55533/2325-5226.1451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2024]
Abstract
Community-based programs may contribute to Latino pediatric obesity prevention; however, attendance remains low. This study aimed to identify factors associated with Latino father/male caregiver attendance in family-based adolescent obesity prevention programs conducted as part of a randomized controlled trial. The study used cross-sectional data from 137 fathers in the program, involving eight weekly sessions to improve their children's energy balance-related behaviors. Evaluation data were collected at baseline and post-intervention. Fathers in a waitlisted control group attended sessions after post-intervention data collection. Attendance patterns were identified using cluster analysis: consistently high attendance (50% of fathers), declining attendance (19%), and non-attendance (31%) clusters. Multinomial logistic regression was used to examine associations between attendance patterns and variables. Compared to consistently high attendance, fathers in the non-attendance cluster were more likely to have been assigned to the control group (odds ratio [OR] = 7.86, p < 0.001), tended to have lower household income (OR = 2.50, p = 0.098), and attended the program at a site where the program occurred weekdays (OR = 0.35, p = 0.094). Maintaining contact during waiting periods and providing sessions online or during weekends could reduce non-attendance by enhancing convenience for low-income fathers working multiple jobs.
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Wood AC, Senn MK, Rotter JI. Associations between Avocado Intake and Lower Rates of Incident Type 2 Diabetes in US Adults with Hispanic/Latino Ancestry. JOURNAL OF DIABETES MELLITUS 2023; 13:116-129. [PMID: 37693693 PMCID: PMC10489295 DOI: 10.4236/jdm.2023.132010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
Background/Purpose Hispanic/Latinos in the US are at increased risk for type 2 diabetes (T2D). Data suggest that avocado intake is associated with better glycemic control, but whether this translates to protection from T2D has not been studied. The goal of the current analyses was to examine whether consuming avocados at baseline is associated with lower incident T2D over a six-year period, compared to not consuming avocados at baseline. Subjects/Methods Using data from a large population of US adults with Hispanic ancestry, without known or unknown T2D at baseline (N=6,159), participants were classified as avocado consumers (N=983) or non-consumers (N=5,176) based on the mean of two 24-hour dietary recalls. Cox proportional hazard models estimated the association of avocado consumption with incident T2D (N=656 cases) over a six-year follow-up period, in the population as a whole, and separately in those with normoglycemia vs. prediabetes at baseline. A set of three sequential models were run: the first controlling only for sociodemographic factors ("minimally adjusted" models), the second for these and health behaviors ("fully adjusted" models), and a third for both sets of covariates and also body mass index (BMI; "fully adjusted + BMI" models). Results In the population as a whole, avocado intake at baseline was associated with reduced incident T2D in both the minimally adjusted (hazard ratio [HR] (+/- 95% confidence intervals [CIs]): 0.70 (0.52 - 0.94), P=.04) and the fully adjusted models (HR: 0.72 (0.54-0.97), P=.03). This association was observed in both those with prediabetes and with normoglycemia at baseline, but only reached significance in those with prediabetes (minimally adjusted model: HR: 0.68 (0.48-0.97), P=.03; fully adjusted model: HR: 0.69 (0.48-0.98), P=.04), not in those with normoglycemia (minimally adjusted model: HR: 0.86 (0.45-1.65), P=.65; fully adjusted model: HR: 0.80 (0.41-1.55), P=.50). In models which additionally controlled for BMI ("fully adjusted + BMI model"), the associations were slightly attenuated (overall population: HR: 0.79 (0.59-1.06), P=.60; normoglycemia: HR: 0.83 (0.42-1.64), P=.60; prediabetes: HR= 0.75 (0.54 - 1.05), P=0.09). Conclusions In our longitudinal analyses, adults with Hispanic / Latino ancestry who consumed avocado were less likely to develop T2D than those who did not consume avocado at baseline, especially if they had prediabetes at baseline.
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Affiliation(s)
- Alexis C. Wood
- USDA/ARS Children’s Nutrition Research Center, Baylor College of Medicine, 1100 Bates Avenue, Houston, TX 77030. USA
| | - Mackenzie K. Senn
- USDA/ARS Children’s Nutrition Research Center, Baylor College of Medicine, 1100 Bates Avenue, Houston, TX 77030. USA
| | - Jerome I. Rotter
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA 90502. USA
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18
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Kandula NR, Islam N, Needham BL, Ahmed N, Thorpe L, Kershaw KN, Chen E, Zakai NA, Kanaya AM. A multilevel framework to investigate cardiovascular health disparities among South Asian immigrants in the United States. Ann Epidemiol 2023; 81:24-30.e1. [PMID: 36898570 PMCID: PMC10101928 DOI: 10.1016/j.annepidem.2023.02.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 02/20/2023] [Accepted: 02/28/2023] [Indexed: 03/11/2023]
Abstract
PURPOSE Prior studies of cardiovascular health (CVH) disparities among immigrants of South Asian origin in the United States have examined South Asians as one homogenous group, focused primarily on Indian-origin immigrants, and examined risk at the individual level. METHODS We present current knowledge and evidence gaps about CVH in the three largest South Asian-origin populations in the United States-Bangladeshi, Indian, and Pakistani-and draw on socioecological and lifecourse frameworks to propose a conceptual framework for investigating multilevel risk and protective factors of CVH across these groups. RESULTS The central hypothesis is that CVH disparities among South Asian populations exist due to differences in structural and social determinants, including lived experiences like discrimination, and that acculturation strategies and resilience resources (e.g., neighborhood environment, education, religiosity, social support) ameliorate stressors to act as health protective factors. RESULTS Conclusions: Our framework advances conceptualization of the heterogeneity and drivers of cardiovascular disparities in diverse South Asian-origin populations. We present specific recommendations to inform the design of future epidemiologic studies on South Asian immigrant health and the development of multilevel interventions to reduce CVH disparities and promote well-being.
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Affiliation(s)
- Namratha R Kandula
- Department of Medicine, Feinberg School of Medicine Northwestern University, Chicago, IL; Department of Preventive Medicine, Feinberg School of Medicine Northwestern University, Chicago, IL.
| | - Nadia Islam
- Department of Population Health, NYU Grossman School of Medicine, New York, NY
| | - Belinda L Needham
- Department of Epidemiology and Center for Social Epidemiology and Population Health, University of Michigan, Ann Arbor
| | - Naheed Ahmed
- Department of Population Health, NYU Grossman School of Medicine, New York, NY
| | - Lorna Thorpe
- Department of Population Health, NYU Grossman School of Medicine, New York, NY
| | - Kiarri N Kershaw
- Department of Preventive Medicine, Feinberg School of Medicine Northwestern University, Chicago, IL
| | - Edith Chen
- Institute for Policy Research and Department of Psychology, Northwestern University, Chicago, IL
| | - Neil A Zakai
- Department of Medicine, Larner College of Medicine, University of Vermont, Burlington; Department of Pathology & Laboratory Medicine, Larner College of Medicine, University of Vermont, Burlington
| | - Alka M Kanaya
- Department of Medicine, Epidemiology & Biostatistics, University of California, San Francisco
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Lamar M, Estrella ML, Capuano AW, Leurgans S, Fleischman DA, Barnes LL, Lange‐Maia BS, Bennett DA, Marquez DX. A Longitudinal Study of Acculturation in Context and Cardiovascular Health and Their Effects on Cognition Among Older Latino Adults. J Am Heart Assoc 2023; 12:e027620. [PMID: 36926993 PMCID: PMC10111521 DOI: 10.1161/jaha.122.027620] [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: 07/25/2022] [Accepted: 01/23/2023] [Indexed: 03/18/2023]
Abstract
Background We previously outlined the importance of considering acculturation within the context of older Latino adults' lived experience (ie, acculturation in context) to better capture contributors to cognitive aging. We now examine this conceptual framework as related to level of and change in cardiovascular health, and whether cardiovascular health modifies previously documented associations of acculturation in context with cognition. Methods and Results Acculturation in context data from 192 Latino participants without dementia at baseline (age ~70 years) were compiled into 3 separate composite scores: acculturation-related (nativity, language-, and social-based preferences), contextually related socioenvironmental (experiences of discrimination, social isolation, social networks), and familism-related (Latino-centric family ethos). A modified American Heart Association's Life's Simple 7 (mLS7; ie, smoking, physical activity, body mass index, blood pressure, total cholesterol, blood glucose) was used to measure cardiovascular health. Mixed effects regressions simultaneously tested the association of all 3 composite scores with total mLS7 adjusting for confounders. Separate models tested whether mLS7 modified associations of the 3 composite scores and cognition. The contextually related socioenvironmental composite score reflecting higher discrimination, higher social isolation, and smaller social networks (estimate=0.22, SE=0.10, P=0.02) and the familism score (estimate=0.16, SE=0.07, P=0.02) both significantly associated with change in total mLS7. The acculturation-related composite was not significantly associated with change in mLS7. No composite was significantly associated with level of mLS7. Total mLS7, however, significantly modified associations between the acculturation-related composite and change in working memory (estimate=-0.02, SE=0.01, P=0.043). Conclusions Acculturation within the context of older Latino adults' lived experience is important for maintaining cardiovascular health, relationships that also affect domain-specific cognitive decline.
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Affiliation(s)
- Melissa Lamar
- Rush Alzheimer’s Disease CenterRush University Medical CenterChicagoIL
- Department of Psychiatry and Behavioral SciencesRush University Medical CenterChicagoIL
| | - Mayra L. Estrella
- Department of Epidemiology, Human Genetics and Environmental SciencesUniversity of Texas Health Science Center at Houston School of Public HealthBrownsvilleTX
| | - Ana W. Capuano
- Rush Alzheimer’s Disease CenterRush University Medical CenterChicagoIL
- Department of Neurological SciencesRush University Medical CenterChicagoIL
| | - Sue Leurgans
- Rush Alzheimer’s Disease CenterRush University Medical CenterChicagoIL
- Department of Neurological SciencesRush University Medical CenterChicagoIL
| | - Debra A. Fleischman
- Rush Alzheimer’s Disease CenterRush University Medical CenterChicagoIL
- Department of Psychiatry and Behavioral SciencesRush University Medical CenterChicagoIL
- Department of Neurological SciencesRush University Medical CenterChicagoIL
| | - Lisa L. Barnes
- Rush Alzheimer’s Disease CenterRush University Medical CenterChicagoIL
- Department of Psychiatry and Behavioral SciencesRush University Medical CenterChicagoIL
- Department of Neurological SciencesRush University Medical CenterChicagoIL
| | - Brittney S. Lange‐Maia
- Rush Alzheimer’s Disease CenterRush University Medical CenterChicagoIL
- Department of Preventive MedicineRush University Medical CenterChicagoIL
| | - David A. Bennett
- Rush Alzheimer’s Disease CenterRush University Medical CenterChicagoIL
- Department of Neurological SciencesRush University Medical CenterChicagoIL
| | - David X. Marquez
- Rush Alzheimer’s Disease CenterRush University Medical CenterChicagoIL
- Department of Kinesiology and NutritionUniversity of Illinois ChicagoChicagoIL
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20
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Mahadevan M, Bose M, Gawron KM, Blumberg R. Metabolic Syndrome and Chronic Disease Risk in South Asian Immigrants: A Review of Prevalence, Factors, and Interventions. Healthcare (Basel) 2023; 11:healthcare11050720. [PMID: 36900725 PMCID: PMC10000781 DOI: 10.3390/healthcare11050720] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 02/21/2023] [Accepted: 02/26/2023] [Indexed: 03/05/2023] Open
Abstract
South Asians (SAs) are among the fastest-growing ethnic groups in the U.S. Metabolic syndrome (MetS) is a condition that is characterized by multiple health factors that increase the risk for chronic diseases, such as cardiovascular disease (CVD) and diabetes. MetS prevalence among SA immigrants ranges from 27-47% in multiple cross-sectional studies using different diagnostic criteria, which is generally higher compared to other populations in the receiving country. Both genetic and environmental factors are attributed to this increased prevalence. Limited intervention studies have shown effective management of MetS conditions within the SA population. This review reports MetS prevalence in SAs residing in non-native countries, identifies contributing factors, and discusses ways to develop effective community-based strategies for health promotion targeting MetS among SA immigrants. There is a need for more consistently evaluated longitudinal studies to facilitate the development of directed public health policy and education to address chronic diseases in the SA immigrant community.
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Affiliation(s)
- Meena Mahadevan
- Department of Nutrition and Food Studies, Montclair State University, Montclair, NJ 07043, USA
- Correspondence: ; Tel.: +1-973-655-7574
| | - Mousumi Bose
- Department of Nutrition and Food Studies, Montclair State University, Montclair, NJ 07043, USA
| | | | - Renata Blumberg
- Department of Nutrition and Food Studies, Montclair State University, Montclair, NJ 07043, USA
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21
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Shah MK, Gandrakota N, Gujral UP, Islam N, Narayan KMV, Ali MK. Cardiometabolic Risk in Asian Americans by Social Determinants of Health: Serial Cross-sectional Analyses of the NHIS, 1999-2003 to 2014-2018. J Gen Intern Med 2023; 38:571-581. [PMID: 36418646 PMCID: PMC9971386 DOI: 10.1007/s11606-022-07933-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 11/01/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Diabetes and hypertension are common in Asian Americans and vary by subgroup. There may be further variation by social determinants of health (SDOHs), but few studies have examined this previously. OBJECTIVE To examine the associations of SDOHs and diabetes and hypertension within and across Asian subgroups in the USA DESIGN: Series cross-sectional analyses SETTING: National Health Interview Surveys (NHIS) from 1999 to 2018 PARTICIPANTS: Asian-American adults (Chinese, Filipino, Asian Indian, and Other Asian [Korean, Vietnamese, Japanese, and other]) MEASUREMENTS: Self-reported diabetes and hypertension prevalence in pooled 5-year increments over 1999-2018 and multivariable regression models to assess the adjusted prevalence of diabetes or hypertension by poverty, marital status, education, and years in the USA, adjusting for age, sex, BMI, and health insurance status RESULTS: From 1999-2003 to 2014-2018, the age- and sex-adjusted prevalence of diabetes increased for Other Asians (absolute change: 4.6%) but not for other subgroups; age- and sex-adjusted hypertension prevalence significantly increased for Asian Indians and Other Asians (absolute change: 5-7.5%). For Filipinos, high school education or less was associated with an increase in diabetes prevalence over time (difference from 1999-2003 to 2014-2018: +6.0 (95% CI: 2.0-10.0)), while for Asian Indians, college education or higher was associated with an increase in diabetes prevalence for the same period (difference: +2.7 (95% CI: 0.01-5.4). Differences over the 2 time periods (1999-2003 and 2014-2018) show that Filipino and Other Asians, who lived in the USA for ≥10 years, increased in diabetes prevalence. Similar variations in associations of SDOHs by Asian subgroup were seen for hypertension. LIMITATIONS Self-reported primary outcomes and multi-year data were pooled due to small sample sizes. CONCLUSIONS The influence of SDOHs on cardiometabolic risk is not uniform among Asian Americans, implying tailored strategies may be needed for different population subgroups. PRIMARY FUNDING SOURCE NIH.
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Affiliation(s)
- Megha K Shah
- Department of Family and Preventive Medicine, Emory University School of Medicine, Dunwoody, GA, USA.
| | - Nikhila Gandrakota
- Department of Family and Preventive Medicine, Emory University School of Medicine, Dunwoody, GA, USA
| | - Unjali P Gujral
- Hubert Department of Global Health, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Nadia Islam
- Department of Population Health, NYU School of Medicine, New York, NY, USA
| | - K M Venkat Narayan
- Hubert Department of Global Health, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Mohammed K Ali
- Department of Family and Preventive Medicine, Emory University School of Medicine, Dunwoody, GA, USA
- Hubert Department of Global Health, Emory University Rollins School of Public Health, Atlanta, GA, USA
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22
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Araujo-Menendez CE, Saelzler UG, Stickel AM, Sundermann EE, Banks SJ, Paipilla A, Barnes ML, Panizzon MS. Associations Between Parity and Cognition: Race/Ethnic Differences. J Alzheimers Dis 2023; 94:1157-1168. [PMID: 37393496 PMCID: PMC10473123 DOI: 10.3233/jad-221210] [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] [Accepted: 05/25/2023] [Indexed: 07/03/2023]
Abstract
BACKGROUND Race/ethnicity is associated with differences in reproductive history and cognition individually, yet it remains an understudied factor in the relationship between parity and later-life cognition. OBJECTIVE To evaluate if the association between parity and cognition differs between racial/ethnic groups. METHODS Participants included 778 older, postmenopausal women from the Health and Nutrition Examination Survey (Latina: n = 178, Non-Latino Black [NLB]: n = 169, Non-Latino White [NLW]: n = 431) who self-reported at least one birth. Cognitive outcomes included working memory, learning memory, and verbal fluency. Covariates included age, education, cardiovascular and other reproductive health factors, adult socioeconomic status (SES) and depressive symptoms. We fit a series of linear models to examine a) whether parity was associated with cognitive functioning, b) if this association varied by race/ethnicity through parity by race/ethnicity interactions, and c) individual parity with cognition associations stratified by race/ethnicity. RESULTS In the full sample, parity was significantly negatively associated with Digit Symbol Substitution Test (DSST) performance (b = -0.70, p = 0.024) but not Animal Fluency or word-list learning and memory. Tests of race/ethnicity-by-parity interactions were not statistically significant (ps > 0.05). However, stratified analyses by race/ethnicity showed a differential effect of parity on DSST performance, such that parity was significantly negatively associated with DSST performance (b = -1.66, p = 0.007) among Latinas but not in NLWs (b = -0.16, p = 0.74) or NLBs (b = -0.81, p = 0.191). CONCLUSION Among Latina, but not NLB or NLW women, greater parity was associated with worse processing speed/executive functioning later in life. Further research is needed to understand the mechanisms driving racial/ethnic differences.
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Affiliation(s)
| | - Ursula G. Saelzler
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Ariana M. Stickel
- Department of Psychology, San Diego State University, La Jolla, CA, USA
| | - Erin E. Sundermann
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Sarah J. Banks
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Department of Neurosciences, University of California San Diego, La Jolla, CA, USA
| | - Andrea Paipilla
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - McKinna L. Barnes
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Matthew S. Panizzon
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA, USA
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23
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Al Rifai M, Kianoush S, Jain V, Joshi PH, Cainzos-Achirica M, Nasir K, Merchant AT, Dodani S, Wong SS, Samad Z, Mehta A, Chunara R, Kalra A, Virani SS. Association of U.S. birth, duration of residence in the U.S., and atherosclerotic cardiovascular disease risk factors among Asian adults. Prev Med Rep 2022; 29:101916. [PMID: 35898194 PMCID: PMC9309422 DOI: 10.1016/j.pmedr.2022.101916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 07/07/2022] [Accepted: 07/18/2022] [Indexed: 11/26/2022] Open
Abstract
Introduction Prior studies have shown a direct association between U.S. birth and duration of residence with atherosclerotic cardiovascular disease (ASCVD) though, few have specifically focused on Asian Americans. Methods We utilized cross-sectional data from the 2006 to 2015 National Health Interview Survey. We compared prevalent cardiovascular risk factors and ASCVD among Asian American individuals by U.S. birth and duration of time spent in the U.S. Results The study sample consisted of 18,150 Asian individuals of whom 20.5 % were Asian Indian, 20.5 % were Chinese, 23.4 % were Filipino, and 35.6 % were of other Asian ethnic groups. The mean (standard error) age was 43.8 (0.21) years and 53 % were women. In multivariable-adjusted logistic regression models, U.S. birth was associated with a higher prevalence odds ratio (95 % confidence interval) of current smoking 1.31 (1.07,1.60), physical inactivity 0.62 (0.54,0.72), obesity 2.26 (1.91,2.69), hypertension 1.33 (1.12,1.58), and CAD 1.96 (1.24,3.11), but lower prevalence of stroke 0.28 (0.11,0.71). Spending greater than 15 years in the U.S. was associated with a higher prevalence of current smoking 1.65 (1.24,2.21), obesity 2.33 (1.57,3.47), diabetes 2.68 (1.17,6.15), and hyperlipidemia 1.72 (1.09,2.71). Conclusion Heterogeneity exists in cardiovascular risk factor burden among Asian Americans according to Asian ethnicity, U.S. birth, and duration of time living in the U.S.
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Affiliation(s)
- Mahmoud Al Rifai
- Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, TX, United States
| | - Sina Kianoush
- Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, TX, United States
| | - Vardhmaan Jain
- Department of Medicine, Cleveland Clinic Foundation, Cleveland, OH, United States
| | - Parag H Joshi
- Department of Medicine, Division of Cardiology, UT Southwestern Medical Center, Dallas, TX, United States
| | - Miguel Cainzos-Achirica
- Division of Cardiovascular Prevention and Wellness, Department of Cardiology, Houston Methodist DeBakey Heart & Vascular Center, Houston, TX, United States
| | - Khurram Nasir
- Division of Cardiovascular Prevention and Wellness, Department of Cardiology, Houston Methodist DeBakey Heart & Vascular Center, Houston, TX, United States
| | - Anwar T Merchant
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Sunita Dodani
- Section of Cardiology, Department of Internal Medicine, Eastern Virginia Medical School (EVMS), Norfolk, VA, United States.,EVMS-Sentara Healthcare Analytics and Delivery Science Institute, Norfolk, VA, United States
| | - Sally S Wong
- Office of Science, Medicine and Health, The American Heart Association, Dallas, TX, United States
| | | | - Anurag Mehta
- Division of Cardiology, Department of Medicine, Virginia Commonwealth University Medical Center, Richmond, VA, United States
| | - Rumi Chunara
- Department of Biostatistics, School of Global Public Health, New York University & Department of Computer Science and Engineering, Tandon School of Engineering, New York University, New York, NY, United States
| | - Ankur Kalra
- Department of Cardiovascular Medicine, Heart, Vascular, & Thoracic Institute, Cleveland Clinic, Cleveland, OH, United States
| | - Salim S Virani
- Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, TX, United States.,Section of Cardiology, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, United States.,Health Policy, Quality & Informatics Program, Michael E. DeBakey VA Medical Center Health Services Research & Development Center for Innovations in Quality, Effectiveness, and Safety, Houston, TX, United States.,Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, TX, United States
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24
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Li CC, Matthews AK, Yen PS, Chen YF, Dong X. The influence of perceived discrimination in healthcare settings on psychological distress among a diverse sample of older Asian Americans. Aging Ment Health 2022; 26:1874-1881. [PMID: 34319179 DOI: 10.1080/13607863.2021.1958146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES The purpose of this study was to determine the relationship between discrimination in healthcare settings and psychological distress. METHOD This study utilized a retrospective cross-sectional study design. The dataset was obtained from 2015-2017 California Health Interview Survey (CHIS). Healthcare discrimination experience (yes, no) was measured using the following question "Over your entire lifetime, how often have you been treated unfairly when getting medical care (never, rarely, sometimes, often)?". Psychological distress was the study outcome and was measured using the Kessler Psychological Distress Scale. A composite score (0-24) was created for psychological distress for the prior 30 days and for the worse most in the past 12 months. A hierarchical multivariate linear regression was conducted to examine the influence of healthcare discrimination experience on psychological distress after adjusting for other covariates. RESULTS Study participants (weighted N = 1,360,487) had a mean age of 64.35 years (SD = 0.61), were primarily female (54.93%), heterosexual (96.61%), and married or living with a partner (73.37%). About 10.00% of older Asian Americans ever perceived healthcare discrimination over their entire lifetime. Perceived discrimination was associated with higher levels of psychological distress for the past 30 days (beta= 2.107, SE = 0.662, p < 0.05) and for the worst month in the past year (beta= 2.099, SE = 0.697, p < 0.05) after controlling for covariates. CONCLUSION Self-reported discrimination was relatively low in this sample of older Asian American adults. However, consistent with prior research, perceived discrimination in the healthcare setting was associated with increased psychological distress. The findings have implications for improving the quality of health care services received.
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Affiliation(s)
- Chien-Ching Li
- Department of Health Systems Management, Rush University, Chicago, Illinois, USA
| | - Alicia K Matthews
- Department of Population Health Nursing Science, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Pei-Shan Yen
- Center for Clinical Translational Science, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Yi-Fan Chen
- Center for Clinical Translational Science, University of Illinois at Chicago, Chicago, Illinois, USA
| | - XinQi Dong
- Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, New Jersey, USA
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25
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Post WS, Watson KE, Hansen S, Folsom AR, Szklo M, Shea S, Barr RG, Burke G, Bertoni AG, Allen N, Pankow JS, Lima JA, Rotter JI, Kaufman JD, Johnson WC, Kronmal RA, Diez-Roux AV, McClelland RL. Racial and Ethnic Differences in All-Cause and Cardiovascular Disease Mortality: The MESA Study. Circulation 2022; 146:229-239. [PMID: 35861763 PMCID: PMC9937428 DOI: 10.1161/circulationaha.122.059174] [Citation(s) in RCA: 43] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 06/07/2022] [Indexed: 12/17/2022]
Abstract
BACKGROUND Despite improvements in population health, marked racial and ethnic disparities in longevity and cardiovascular disease (CVD) mortality persist. This study aimed to describe risks for all-cause and CVD mortality by race and ethnicity, before and after accounting for socioeconomic status (SES) and other factors, in the MESA study (Multi-Ethnic Study of Atherosclerosis). METHODS MESA recruited 6814 US adults, 45 to 84 years of age, free of clinical CVD at baseline, including Black, White, Hispanic, and Chinese individuals (2000-2002). Using Cox proportional hazards modeling with time-updated covariates, we evaluated the association of self-reported race and ethnicity with all-cause and adjudicated CVD mortality, with progressive adjustments for age and sex, SES (neighborhood SES, income, education, and health insurance), lifestyle and psychosocial risk factors, clinical risk factors, and immigration history. RESULTS During a median of 15.8 years of follow-up, 22.8% of participants (n=1552) died, of which 5.3% (n=364) died of CVD. After adjusting for age and sex, Black participants had a 34% higher mortality hazard (hazard ratio [HR], 1.34 [95% CI, 1.19-1.51]), Chinese participants had a 21% lower mortality hazard (HR, 0.79 [95% CI, 0.66-0.95]), and there was no mortality difference in Hispanic participants (HR, 0.99 [95% CI, 0.86-1.14]) compared with White participants. After adjusting for SES, the mortality HR for Black participants compared with White participants was reduced (HR, 1.16 [95% CI, 1.01-1.34]) but still statistically significant. With adjustment for SES, the mortality hazards for Chinese and Hispanic participants also decreased in comparison with White participants. After further adjustment for additional risk factors and immigration history, Hispanic participants (HR, 0.77 [95% CI, 0.63-0.94]) had a lower mortality risk than White participants, and hazard ratios for Black participants (HR, 1.08 [95% CI, 0.92-1.26]) and Chinese participants (HR, 0.81 [95% CI, 0.60-1.08]) were not significantly different from those of White participants. Similar trends were seen for CVD mortality, although the age- and sex-adjusted HR for CVD mortality for Black participants compared with White participants was greater than all-cause mortality (HR, 1.72 [95% CI, 1.34-2.21] compared with HR, 1.34 [95% CI, 1.19-1.51]). CONCLUSIONS These results highlight persistent racial and ethnic differences in overall and CVD mortality, largely attributable to social determinants of health, and support the need to identify and act on systemic factors that shape differences in health across racial and ethnic groups.
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Affiliation(s)
- Wendy S. Post
- Division of Cardiology, Department of Medicine, Johns Hopkins University, Baltimore, MD
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - Karol E Watson
- Division of Cardiology, Department of Internal Medicine, UCLA, Los Angeles, CA
| | - Spencer Hansen
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Aaron R. Folsom
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, MN
| | - Moyses Szklo
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - Steven Shea
- Department of Medicine, Vagelos College of Physicians & Surgeons, and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - R. Graham Barr
- Department of Medicine, Vagelos College of Physicians & Surgeons, and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Gregory Burke
- Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC
| | - Alain G. Bertoni
- Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC
| | - Norrina Allen
- Department of Preventive Medicine, Northwestern University, Chicago, IL
| | - James S. Pankow
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, MN
| | - Joao A.C. Lima
- Division of Cardiology, Department of Medicine, Johns Hopkins University, Baltimore, MD
| | - Jerome I. Rotter
- The Lundquist Institute, Harbor-UCLA Medical Center, Torrance, CA
| | - Joel D. Kaufman
- Environmental & Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - W, Craig Johnson
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | | | - Ana V. Diez-Roux
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA
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Morey BN, Ryu S, Shi Y, Park HW, Lee S. Acculturation and Cardiometabolic Abnormalities Among Chinese and Korean Americans. J Racial Ethn Health Disparities 2022:10.1007/s40615-022-01347-x. [PMID: 35705844 PMCID: PMC9200372 DOI: 10.1007/s40615-022-01347-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 05/16/2022] [Accepted: 05/31/2022] [Indexed: 11/26/2022]
Abstract
Background Studies generally show that higher acculturation is associated with greater cardiovascular disease (CVD) risk among immigrants in the United States (US). However, few studies have compared how proxies of acculturation are differentially associated with metabolic abnormalities measured using objective biomarkers, self-reported diagnosis, and medication use, particularly among East Asian Americans. Methods Survey data and biomarker measurements collected from random (non-fasting) blood samples of Chinese and Korean immigrants in the US (n = 328) were used to examine the associations between two proxies for acculturation (years living in the US and English speaking proficiency) with three cardiometabolic abnormalities (high triglyceride levels, diabetes, and hypercholesterolemia). Poisson regression models estimated prevalence ratios adjusted for demographic characteristics, socioeconomic factors, and body mass index. Gender, Asian subgroup, and household income were tested as potential effect modifiers. Results Living longer in the US was associated with greater likelihood of having high triglycerides. In addition, living longer in the US was associated with greater likelihood of diabetes for people with lower household income and greater likelihood of hypercholesterolemia for people with higher household income. Higher level of English proficiency was less consistently associated with higher cardiometabolic risk, although there was a significant association with greater likelihood of hypercholesterolemia. Conclusions Longer time lived in the US is associated with higher risk of cardiometabolic abnormalities among Chinese and Korean Americans. Future studies of acculturation and cardiometabolic risk should carefully consider potential mechanisms and what proxy measures of acculturation capture. Trial Registration Number NCT03481296, date of registration: 3/29/2018.
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Affiliation(s)
- Brittany N Morey
- Program in Public Health, Department of Health, Society, & Behavior, University of California, Irvine, 653 E. Peltason Dr., Anteater Instruction and Research Building (AIRB) 2022, Irvine, CA, 92697-3957, USA.
| | - Soomin Ryu
- School of Public Policy, University of Maryland, College Park, MD, USA
| | - Yuxi Shi
- Department of Medicine, School of Medicine, University of California, Irvine, Irvine, CA, USA
| | - Hye Won Park
- Department of Medicine, School of Medicine, University of California, Irvine, Irvine, CA, USA
| | - Sunmin Lee
- Department of Medicine, School of Medicine, University of California, Irvine, Irvine, CA, USA
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De Souza LR, Chan KT, Kobayashi K, Karasiuk A, Fuller-Thomson E. The prevalence and management of diabetes among Vietnamese Americans: A population-based survey of an understudied ethnic group. Chronic Illn 2022; 18:306-319. [PMID: 33054356 DOI: 10.1177/1742395320959422] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Although obesity remains relatively rare among Vietnamese Americans, the prevalence of diabetes has increased in this population. This study aims to: 1. Estimate the prevalence of diabetes among non-obese Vietnamese American adults compared to non-obese non-Hispanic whites (NHW). 2. Identify factors associated with diabetes among non-obese Vietnamese Americans. 3. Examine whether Vietnamese Americans and NHW with diabetes are equally as likely to receive optimal frequency of diabetes care (i.e., hemoglobin A1C monitoring, foot care, eye care). METHODS We conducted a secondary analysis of non-obese adult Vietnamese Americans using pooled data from the 2007, 2009, 2011 and 2013-2016 waves of the California Health Interview Survey (CHIS). RESULTS Only 9% of Vietnamese Americans with diabetes are obese. Non-obese Vietnamese Americans have 60% higher adjusted odds of diabetes compared to non-obese NHW. Among non-obese Vietnamese Americans, those who were older, ever smokers and born outside US had a higher prevalence of diabetes. We found both Vietnamese Americans and NHW with diabetes received similar levels of care. DISCUSSION Non-obese Vietnamese Americans have much higher odds of diabetes than NHW. Health professionals can effectively minimize disparities between Vietnamese Americans and NHW with diabetes through appropriate monitoring of foot care, eye care and A1C levels.
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Affiliation(s)
- Leanne R De Souza
- Institute for Life Course and Aging, University of Toronto, Toronto, Canada
| | - Keith T Chan
- School of Social Welfare, University at Albany, Albany, USA
| | - Karen Kobayashi
- Department of Sociology, University of Victoria, Victoria, Canada
| | - Alexis Karasiuk
- Institute for Life Course and Aging, University of Toronto, Toronto, Canada
| | - Esme Fuller-Thomson
- Institute for Life Course and Aging, University of Toronto, Toronto, Canada.,Factor-Inwentash Faculty of Social Work and Department of Family & Community Medicine, University of Toronto, Toronto, Canada
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Nmezi NA, Turkson-Ocran RA, Tucker CM, Commodore-Mensah Y. The Associations between Depression, Acculturation, and Cardiovascular Health among African Immigrants in the United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:6658. [PMID: 35682247 PMCID: PMC9180644 DOI: 10.3390/ijerph19116658] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 05/17/2022] [Accepted: 05/18/2022] [Indexed: 02/02/2023]
Abstract
Cardiovascular disease (CVD) is the leading cause of death both globally and in the United States (U.S.). Racial health disparities in cardiovascular health (CVH) persist with non-Hispanic Black adults having a higher burden of CVD morbidity and mortality compared to other racial groups. African immigrants represent an increasingly growing sub-population of the overall U.S. non-Hispanic Black adult population, however little is known about how specific psychological and social factors (i.e., depression and acculturation) influence the CVH of U.S. African immigrants. We sought to examine the association between severity of depression symptomology and CVH among African immigrants, and whether acculturation moderated the relationship between severity of depression symptoms and CVH. Study participants were those in the African Immigrant Health Study conducted in the Baltimore-Washington D.C. area. Severity of depression symptoms were assessed using the Patient Health Questionnaire-8 (PHQ-8). CVH was assessed using the American Heart Association Life's Simple 7 metrics and categorized as poor, intermediate, and ideal CVH. Acculturation measured as length of stay and acculturation strategy was examined as a moderator variable. Multivariable logistic regression was used to examine the association between depression and CVH and the moderating effect of acculturation adjusting for known confounders. In total 317 African immigrants participated in the study. The mean (±SD) age of study participants was 46.9 (±11.1) and a majority (60%) identified as female. Overall, 8.8% of study participants endorsed moderate-to-severe symptoms of depression. African immigrants endorsing moderate-to-severe levels of depression were less likely to have ideal CVH compared to those with minimal-to-mild symptoms of depression (Adjusted Odds Ratio [AOR]: 0.42, 95% CI: 0.17-0.99). Acculturation measured either as length of stay or acculturation strategy did not moderate the relationship between depression and CVH among study participants. Study participants exhibited elevated levels of symptoms of depression. Greater severity of depression symptoms was associated with worse CVH. Efforts to treat and prevent CVD among African immigrants should also include a focus on addressing symptoms of depression within this population.
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Affiliation(s)
- Nwakaego A. Nmezi
- Division of Rehabilitation Psychology and Neuropsychology, Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Ruth-Alma Turkson-Ocran
- Section for Research, Division of General Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA;
| | - Carolyn M. Tucker
- Department of Psychology, University of Florida, Gainesville, FL 32611, USA;
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Zou P, Ba D, Luo Y, Yang Y, Zhang C, Zhang H, Wang Y. Dietary Characteristics and Influencing Factors on Chinese Immigrants in Canada and the United States: A Scoping Review. Nutrients 2022; 14:nu14102166. [PMID: 35631309 PMCID: PMC9147302 DOI: 10.3390/nu14102166] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 05/13/2022] [Accepted: 05/18/2022] [Indexed: 02/01/2023] Open
Abstract
Background: Chinese immigrants are an integral part of Canadian and American society. Chinese immigrants believe diet to be an important aspect of health, and dietary behaviours in this population have been associated with changes in disease risk factors and disease incidence. This review aims to summarize the characteristics of the dietary behaviours of Chinese immigrants and the associated influencing factors to better inform individual, clinical, and policy decisions. Methods: This scoping review was written in accordance with PRISMA guidelines. MEDLINE, PsychINFO, CINAHL, AgeLine, ERIC, ProQuest, Nursing and Allied Health Database, PsychARTICLES, and Sociology Database were utilized for the literature search. Articles were included if they explored dietary or nutritional intake or its influencing factors for Chinese immigrants to Canada or the United States. Results: A total of 51 papers were included in this review. Among Chinese immigrants in Canada and the United States, the intake of fruits and vegetables, milk and alternatives, and fiber were inadequate against national recommendations. Chinese immigrants showed increased total consumption of food across all food groups and adoption of Western food items. Total caloric intake, meat and alternatives intake, and carbohydrate intake increased with acculturation. Individual factors (demographics, individual preferences, and nutritional awareness), familial factors (familial preferences and values, having young children in the family, and household food environment), and community factors (accessibility and cultural conceptualizations of health and eating) influenced dietary behaviours of Chinese immigrants. Discussion and Conclusion: Efforts should be undertaken to increase fruit, vegetable, and fibre consumption in this population. As dietary acculturation is inevitable, efforts must also be undertaken to ensure that healthy Western foods are adopted. It is important for healthcare providers to remain culturally sensitive when providing dietary recommendations. This can be achieved through encouragement of healthy ethnocultural foods and acknowledgement and incorporation of traditional health beliefs and values into Western evidence-based principles where possible.
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Affiliation(s)
- Ping Zou
- School of Nursing, Nipissing University, 222 St. Patrick Street, Suite 618, Toronto, ON M5T 1V4, Canada
- Correspondence: (P.Z.); (Y.W.); Tel.: +416-642-7003 (P.Z.)
| | - Dong Ba
- Faculty of Health Sciences, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4L8, Canada;
| | - Yan Luo
- Faculty of Nursing, Health Science Center, Xi’an Jiaotong University, No. 76 Yanta West Road, Xi’an 710061, China;
| | - Yeqin Yang
- School of Nursing, Wenzhou Medical University, Chashan Higher Education Park, Wenzhou 325035, China; (Y.Y.); (C.Z.)
| | - Chunmei Zhang
- School of Nursing, Wenzhou Medical University, Chashan Higher Education Park, Wenzhou 325035, China; (Y.Y.); (C.Z.)
| | - Hui Zhang
- Department of Cardiology, Guizhou Provincial People’s Hospital, Guiyang 550002, China;
| | - Yao Wang
- Xiang Ya School of Nursing, Central South University, Changsha 410013, China
- Correspondence: (P.Z.); (Y.W.); Tel.: +416-642-7003 (P.Z.)
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Pachipala K, Shankar V, Rezler Z, Vittal R, Ali SH, Srinivasan MS, Palaniappan L, Yang E, Juul F, Elfassy T. Acculturation and Associations with Ultra-processed Food Consumption among Asian Americans: NHANES, 2011-2018. J Nutr 2022; 152:1747-1754. [PMID: 35389482 PMCID: PMC9258532 DOI: 10.1093/jn/nxac082] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 03/18/2022] [Accepted: 03/31/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Ultra-processed food (UPF) consumption is linked to adverse health outcomes, including cardiovascular disease and all-cause mortality. Asian Americans (AAs) are the fastest growing ethnic group in the United States, yet their dietary patterns have seldom been described. OBJECTIVES The aim was to characterize UPF consumption among AAs and determine whether acculturation is associated with increased UPF consumption. METHODS The NHANES is an annual, cross-sectional survey representative of the US population. We examined 2011-2018 NHANES data, which included 2404 AAs ≥18 y old with valid 24-h dietary recall. Using day 1 dietary recall data, we characterized UPF consumption as the percentage of caloric intake from UPFs, using the NOVA classification system. Acculturation was characterized by nativity status, nativity status and years in the United States combined, home language, and an acculturation index. We assessed the association between acculturation and UPF consumption using linear regression analyses adjusted for age, sex, marital status, education, income, self-reported health, and self-reported diet quality. RESULTS UPFs provided, on average, 39.3% (95% CI: 38.1%, 40.5%) of total energy intake among AAs. In adjusted regression analyses, UPF consumption was 14% (95% CI: 9.5%, 17.5%; P < 0.05) greater among those with the highest compared with the lowest acculturation index score, 12% (95% CI: 8.5%, 14.7%: P < 0.05) greater among those who speak English only compared with non-English only in the home, 12% (95% CI: 8.6%, 14.7%: P < 0.05) greater among US-born compared with foreign-born AAs, and 15% (95% CI: 10.7%, 18.3%: P < 0.05) greater among US-born compared with foreign-born AAs with <10 y in the United States. CONCLUSIONS UPF consumption was common among AAs, and acculturation was strongly associated with greater proportional UPF intake. As the US-born AA population continues to grow, UPF consumption in this group is likely to increase. Further research on disaggregated AA subgroups is warranted to inform culturally tailored dietary interventions.
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Affiliation(s)
- Krithi Pachipala
- Stanford Center for Asian Health Research and Education (CARE), Stanford University School of Medicine, Stanford, CA, USA
| | - Vishal Shankar
- Stanford Center for Asian Health Research and Education (CARE), Stanford University School of Medicine, Stanford, CA, USA
| | - Zachary Rezler
- Stanford Center for Asian Health Research and Education (CARE), Stanford University School of Medicine, Stanford, CA, USA
| | - Ranjana Vittal
- Stanford Center for Asian Health Research and Education (CARE), Stanford University School of Medicine, Stanford, CA, USA
| | - Shahmir H Ali
- Department of Social and Behavioral Sciences, New York University School of Global Public Health, New York, NY, USA
| | - Malathi S Srinivasan
- Stanford Center for Asian Health Research and Education (CARE), Stanford University School of Medicine, Stanford, CA, USA
| | - Latha Palaniappan
- Stanford Center for Asian Health Research and Education (CARE), Stanford University School of Medicine, Stanford, CA, USA
| | - Eugene Yang
- Stanford Center for Asian Health Research and Education (CARE), Stanford University School of Medicine, Stanford, CA, USA,Department of Medicine, Division of Cardiology, University of Washington School of Medicine, Seattle, WA, USA
| | - Filippa Juul
- Department of Public Health Policy and Management, New York University School of Global Public Health, New York, NY, USA
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Min LY, Islam RB, Gandrakota N, Shah MK. The social determinants of health associated with cardiometabolic diseases among Asian American subgroups: a systematic review. BMC Health Serv Res 2022; 22:257. [PMID: 35216607 PMCID: PMC8876533 DOI: 10.1186/s12913-022-07646-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 02/16/2022] [Indexed: 12/03/2022] Open
Abstract
Background Asian Americans represent one of the fastest-growing immigrant groups in the U.S. and are at high risk for cardiometabolic diseases (CMDs), including type 2 diabetes, hypertension, coronary artery disease, and stroke. Despite the growth of Asians in the U. S, there is a gap in understanding the heterogeneity of CMDs across Asian subgroups and how these might be affected by the social determinants of health (SDOH), or the environment in which people live and work. Objective The purpose of this systematic review is to examine the current literature on CMDs among Asian Americans and identify the SDOH that are associated with the incidence and/or prevalence of CMDs among specific Asian subgroups. Methods PubMed, Embase, Web of Science were searched for articles published in Jan 2000-Nov 2020. The reproducible strategy yielded 2732 articles. The articles were reviewed based on the following inclusion criteria: (1) observational study published in the U.S., (2) adult population includes specific Asian subgroups, (3) exposures include SDOH, and (4) outcomes include a CMD, defined as type 2 diabetes, hypertension, coronary artery disease, or stroke. Results In this review, 14 studies were identified and organized into four key themes: acculturation (n = 9), socioeconomic status (SES) (n = 6), social context (n = 2), and health literacy (n = 1). The most represented Asian subgroups in the literature were Chinese, Filipino, and South Asians. Acculturation was the most described social factor in the included reviews. Seven studies found associations between higher acculturation levels and higher prevalence of CMD. However, the measure of acculturation varied by study and included various combinations of the country of birth, number of years residing in the U.S., and English proficiency. The effects of SES, measured as income level and educational attainment, varied by racial subgroups. One study found that higher levels of education were associated with CMD among South Asians. Conclusion Acculturation, SES, social context, and health literacy impact the risk of CMD among Asian Americans; these vary across subgroups. Future research disentangling SDOHs on the risk of CMDs by Asian subgroup is necessary to provide better informed preventive practices and interventions. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-07646-7.
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Affiliation(s)
- Lucy Y Min
- University of Miami Miller School of Medicine, Miami, FL, USA
| | - Rehnuma B Islam
- Department of Family and Preventive Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Nikhila Gandrakota
- Department of Family and Preventive Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Megha K Shah
- Department of Family and Preventive Medicine, Emory University School of Medicine, Atlanta, GA, USA.
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Choi D, Narayan KMV, Patel SA. Disparities in diabetes between US-born and foreign-born population: using three diabetes indicators. BIODEMOGRAPHY AND SOCIAL BIOLOGY 2022; 67:16-27. [PMID: 35466846 PMCID: PMC9039242 DOI: 10.1080/19485565.2021.2016368] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
We investigated disparities in diabetes between the US-born and foreign-born populations using three diabetes measures: diagnosed diabetes, undiagnosed diabetes, and total diabetes, either diagnosed or undiagnosed diabetes. We analyzed adults aged 30-84 years drawn from the National Health and Nutrition Examination Survey 2009-2018 (n = 21,390). Of cohorts in 2009-2018, foreign-born adults had significantly higher age-standardized prevalence of diagnosed (12.6% vs. 10.6%) and undiagnosed diabetes (4.5% vs. 2.6%), and total diabetes (17.1% vs. 13.2%) than US-born adults. Results from logistic and multinomial regressions adjusting for age, sex, race/ethnicity, limited access to healthcare and BMI showed that the foreign-born had significantly higher odds of total diabetes (OR: 1.25, 95% CI: 1.04-1.50) and undiagnosed diabetes (OR: 1.83, 95% CI: 1.44-2.32) compared to the US-born. There was no significant difference in diagnosed diabetes by nativity (OR: 1.12, 95% CI: 0.96-1.53). Our results show that foreign-born adults were at higher risk of diabetes than US-born adults, and the difference by nativity was largely attributable to BMI and racial/ethnic composition. In addition, we demonstrated the importance of choosing measures of diabetes in studying diabetes mainly due to the foreign-born group's high prevalence of undiagnosed diabetes, which biases the prevalence of diabetes downward when diagnosed diabetes is used.
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Affiliation(s)
- Daesung Choi
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - K M Venkat Narayan
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Shivani A Patel
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
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Daniel GD, Chen H, Bertoni AG, Rapp SR, Fitzpatrick AL, Luchsinger JA, Wood AC, Hughes TM, Burke GL, Hayden KM. DASH diet adherence and cognitive function: Multi-ethnic study of atherosclerosis. Clin Nutr ESPEN 2021; 46:223-231. [PMID: 34857201 PMCID: PMC8812811 DOI: 10.1016/j.clnesp.2021.10.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 09/16/2021] [Accepted: 10/04/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND AND AIMS The Adherence to the Dietary Approaches to Stop Hypertension (DASH) diet has been associated with better cognitive function in studies of predominantly White participants; few studies have examined this association in diverse cohorts. Our objective was to examine the association between the DASH diet and cognitive function in the diverse Multi-Ethnic Study of Atherosclerosis (MESA) cohort. METHODS Among 4169 MESA participants, we evaluated prospectively, the association between DASH diet adherence and cognitive function. Participants completed a food frequency questionnaire at baseline (2000-2002) and cognitive function was assessed using the Cognitive Abilities Screening Instrument (CASI), Digit Symbol Coding (DSC), and Digit Span (DS) at Exam 5 in 2010-2012 and Exam 6 (2016-2019). Regression analyses were used to evaluate the association between quintiles of DASH diet adherence with CASI, DSC, and DS performance and decline, adjusting for potential confounders. Effect modification by hypertension, diabetes, race/ethnicity, acculturation, and exercise were evaluated. RESULTS DASH diet adherence was not associated with cognitive performance or decline for any of the measures. There were no differences by racial/ethnic groups, with the exception that Hispanic participants reporting greater DASH diet adherence, performed worse on DS at Exam 5 (p = 0.05). Components of the DASH diet were differentially correlated with test performance: increased consumption of nuts/legumes was associated with better performance on the CASI at Exam 5 (p = 0.003) and Exam 6 (p = 0.007). Increased consumption of whole grains was associated with better DSC performance at Exam 5 (p = 0.04) and better DS performance at Exam 6 (p = 0.01). CONCLUSIONS DASH diet adherence was nominally associated with cognitive function with a suggestion of differences by race/ethnicity. Future work should examine more closely, the relationships between racial and ethnic groups and the impact of diet on cognitive function.
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Affiliation(s)
- George D Daniel
- Department of Neurobiology and Anatomy, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Haiying Chen
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Alain G Bertoni
- Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Stephen R Rapp
- Department of Psychiatry & Behavioral Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA; Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | | | - José A Luchsinger
- Departments of Medicine and Epidemiology, Columbia University Irving Medical Center, New York, NY, USA
| | - Alexis C Wood
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, USA
| | - Timothy M Hughes
- Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC, USA; Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Gregory L Burke
- Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Kathleen M Hayden
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA.
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Sanjeevi N. Mediation of the Relationship of Acculturation With Glycemic Control in Asian Americans With Diabetes. Am J Health Promot 2021; 36:279-287. [PMID: 34787493 DOI: 10.1177/08901171211052562] [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: 11/15/2022]
Abstract
PURPOSE To assess the role of physical activity and healthcare access in mediating the association of acculturation with cardiometabolic health in Asian American adults with diabetes. DESIGN Cross-sectional study. SETTING National Health and Nutrition Examination Survey (NHANES) 2011-2018. SUBJECTS Non-pregnant Asian American adults with doctor diagnosed diabetes. MEASURES Participants were classified into low, moderate, and high acculturation status. Self-reported leisure-time, work, and transportation-based physical activity were summed for overall physical activity. Health insurance, frequency of healthcare receipt, and glycohemoglobin (HbA1c) check in the past year indicated healthcare access. Cardiometabolic health indicators included HbA1c, total and high density lipoprotein-cholesterol, and systolic and diastolic blood pressure. ANALYSIS Linear and logistic regression estimates, standardized using y-standardization, and assessed mediation of acculturation with cardiometabolic health. RESULTS Low acculturation was significantly related to greater leisure-time inactivity odds [OR (95% CI) = 2.25 (1.05, 4.82)], overall insufficient activity [OR (95% CI) = 2.30 (1.12, 4.74)], and uninsured status [OR (95% CI) = 5.62 (1.55, 20.41)]. Asian Americans with low acculturation had significantly higher log HbA1c than those with high acculturation (β ± SE = .078 ± .038); however, this association was not significant after adjusting for leisure-time activity. Leisure-time activity mediated 48.9% of acculturation and HbA1c association, and the indirect effect was statistically significant [estimate (95% CI) = .021 (.002, 0.047)]. CONCLUSIONS Results suggest that promoting sufficient leisure-time activity could improve glycemic control in least acculturated Asian Americans with diabetes.
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Affiliation(s)
- Namrata Sanjeevi
- Department of Nutritional Sciences, College of Natural Sciences, 12330The University of Texas at Austin, Austin, TX, USA
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Mansyur CL, Rustveld LO, Nash SG, Jibaja-Weiss ML. Psychosocial Contributors to Depressive Symptoms in Hispanic Patients With Type 2 Diabetes. Sci Diabetes Self Manag Care 2021; 47:415-424. [PMID: 34715762 DOI: 10.1177/26350106211054420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE The purpose of this study is to identify psychosocial factors associated with depressive symptoms in Hispanic patients with diabetes and explore the extent to which their effects may vary by gender and acculturation. METHODS The authors completed a secondary analysis of data from 247 Hispanic adults with type 2 diabetes. Gender and language groups were compared using chi-square and t tests. Hierarchical multiple regression was used to examine associations of depressive symptoms with perceived support, diabetes-related distress, and social and personal factors. RESULTS Women reported less support than men. English speakers reported more depressive symptoms than Spanish speakers. When adjusting for age, gender, and acculturation, psychosocial factors significantly associated with depressive symptoms included less support received, greater emotional burden, and less ability to socialize or pursue normal activities because of diabetes. CONCLUSIONS Social support provided by family among less acculturated Hispanics may play an important role in reducing emotional burden and lowering the risk of comorbid depression. The quality of interpersonal relationships and the ability to continue normal activities may also be important. More acculturated Hispanic women with diabetes may be at greater risk for comorbid depression and worse health outcomes. Screening for depression and assessment of support needs is warranted for Hispanic women.
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Affiliation(s)
- Carol L Mansyur
- Department of Public Health, California State University, Sacramento, California.,School of Health Professions, Baylor College of Medicine, Houston, Texas.,Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, Texas
| | - Luis O Rustveld
- Department of Family and Community Medicine, Baylor College of Medicine, Houston, Texas.,School of Health Professions, Baylor College of Medicine, Houston, Texas.,Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, Texas
| | - Susan G Nash
- Department of Family and Community Medicine, Baylor College of Medicine, Houston, Texas.,School of Health Professions, Baylor College of Medicine, Houston, Texas.,Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, Texas
| | - Maria L Jibaja-Weiss
- School of Health Professions, Baylor College of Medicine, Houston, Texas.,Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, Texas
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Zhang Y, Nagao-Sato S, Baltaci A, Hurtado Choque GA, Reicks M. Influence of paternal general parenting on Latino early adolescents' energy balance-related behaviours and interactions with behaviour-specific parenting practices. Public Health Nutr 2021; 24:5133-5141. [PMID: 34284840 PMCID: PMC11082802 DOI: 10.1017/s1368980021002846] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 05/28/2021] [Accepted: 06/22/2021] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To investigate the influence of general parenting dimensions on adolescents' energy balance-related behaviours (EBRB) and its interactions with behaviour-specific parenting practices based on Darling and Steinberg's contextual model of parenting style. DESIGN Multiple linear regression analyses and the Hayes PROCESS procedure to analyse self-reported cross-sectional survey data. SETTING In-person survey. PARTICIPANTS Latino early adolescents and their fathers (n 225 dyads) recruited using convenience sampling from metropolitan areas of north-central USA. RESULTS Both paternal parenting dimensions of warmth and autonomy granting were positively associated with adolescents' fruit intake, vegetable intake and physical activity. Coercive control was positively associated with adolescents' sugary drink intake and sweets/salty snack intake. These associations were predominantly mediated by the parenting practices of setting expectations/allowances, role modelling, and managing availability and accessibility for corresponding EBRB. After adjusting for parenting practices, paternal warmth was inversely associated with adolescents' screen time, paternal autonomy was positively associated with sugary drink intake, and both paternal warmth and autonomy granting were positively associated with adolescents' fast food intake. In addition, positive associations between fathers' parenting practices and adolescents' sugary drink intake were significantly stronger among those who perceived high v. low levels of paternal warmth and autonomy granting. CONCLUSIONS Paternal warmth and autonomy granting showed mixed effects on adolescents' EBRB, and coercive control showed undesirable relationships with adolescents' dietary intake via interactions with behaviour-specific parenting practices. Lifestyle intervention programmes for Latino adolescents need to consider incorporating paternal parenting education components.
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Affiliation(s)
- Youjie Zhang
- Department of Child and Adolescent Health and Social Medicine, School of Public Health, Medical College of Soochow University, 199 Ren Ai Road, Suzhou, Jiangsu215123, People’s Republic of China
| | - Sayaka Nagao-Sato
- Department of Food Science and Nutrition, University of Minnesota, Minneapolis, USA
| | - Aysegul Baltaci
- Department of Food Science and Nutrition, University of Minnesota, Minneapolis, USA
| | | | - Marla Reicks
- Department of Food Science and Nutrition, University of Minnesota, Minneapolis, USA
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Jiang Y, Nagao-Sato S, Overcash F, Reicks M. Associations between acculturation and diet and health indicators among U.S. Asian adults: NHANES 2011-2016. J Food Compost Anal 2021. [DOI: 10.1016/j.jfca.2021.104061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Li CC, Matthews AK, Yen PS, Chen YF, Dong X. Intimate partner violence and Its Relationship with Psychological Distress Among Older Asian Americans: Results from the California Health Interview Survey. Asian J Psychiatr 2021; 63:102798. [PMID: 34352510 DOI: 10.1016/j.ajp.2021.102798] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 06/26/2021] [Accepted: 07/22/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE This study aimed to examine the influence of intimate partner violence on psychological distress among a diverse sample of older Asian Americans living in California. METHODS Participants in the 2007-2009 California Health and Interview Survey (CHIS) aged fifty years and older and self-reported as Asian Americans were included in the study. The primary independent variable was the history of any intimate partner violence (physical or sexual violence) since 18 years of age. The Kessler Psychological Distress Six-item Scale was used to measure the study dependent variable. A composite score (0-24) was created for psychological distress during the past 30 days as well as for the one month in the past 12 months when they were at their worst emotionally. Other covariates, including acculturation and demographic factors, were measured. Hierarchical multivariate linear regressions were conducted to examine the influence of intimate partner violence on psychological distress after adjusting for covariates. RESULTS In the study, about 8% of older Asian Americans reported ever experiencing intimate partner violence. After controlling for level of acculturation and demographic factors, a history of intimate partner violence was significantly associated with higher levels of psychological distress for the past month (beta = 2.07, SE = 0.74, p < 0.05) and for the worst month in the past year (beta = 1.99, SE = 0.68, p < 0.05). CONCLUSION Intimate partner violence is a significant risk factor for distress among older Asian Americans. Culturally targeted violence prevention efforts and treatment approaches for individuals impacted by violence are needed in this highly underserved segment of older Americans.
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Affiliation(s)
- Chien-Ching Li
- Rush University, Department of Health Systems Management, Chicago, IL, United States.
| | - Alicia K Matthews
- University of Illinois at Chicago, Department of Population Health Nursing Science, Chicago, IL, United States
| | - Pei-Shan Yen
- University of Illinois at Chicago, Division of Epidemiology and Biostatistics, Chicago, IL, United States
| | - Yi-Fan Chen
- University of Illinois at Chicago, Center for Clinical Translational Science, Chicago, IL, United States
| | - XinQi Dong
- Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, NJ, United States
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Abstract
Diabetes disproportionably affects minorities in the United States. Substantial disparities exist in diabetes incidence, glycemic control, complications, mortality, and management. The most important biologic contributors to diabetes disparities are obesity, insulin resistance, and inadequate glycemic control. Providers and health systems must also recognize the behavioral, social, and environmental factors that promote and sustain racial/ethnic differences in diabetes and its complications. Metformin and sodium-glucose cotransporter 2 inhibitors are the most convenient drugs for treatment of diabetes in minority patients. Multilevel interventions at the patient, provider, health system, community, and policy levels are needed to reduce diabetes disparities in high-risk groups.
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Affiliation(s)
- Nasser Mikhail
- Endocrinology Division, Department of Medicine, Olive View-UCLA Medical Center, David-Geffen-UCLA School of Medicine, Sylmar, CA 91342, USA
| | - Soma Wali
- Department of Medicine, Olive View-UCLA Medical Center, David-Geffen-UCLA School of Medicine, Sylmar, CA 91342, USA
| | - Arleen F Brown
- Department of Medicine, Olive View-UCLA Medical Center, David-Geffen-UCLA School of Medicine, Sylmar, CA 91342, USA.
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Bhattacharya M, Xiong S, McRee AL. Nativity Differences in Awareness and Knowledge About HPV Infection and Vaccination Among U.S. Adults: Findings from a National Population-Based Sample. J Immigr Minor Health 2021; 24:794-798. [PMID: 34455520 DOI: 10.1007/s10903-021-01268-7] [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] [Accepted: 08/21/2021] [Indexed: 10/20/2022]
Abstract
Foreign-born populations in the United States suffer multiple disparities related to human papillomavirus, including higher cervical cancer mortality and lower HPV vaccination. No nationally based studies have examined the relationship between nativity with HPV and HPV vaccination awareness and knowledge, especially examining acculturation, an immigration-specific process affecting health-related behaviors. We assessed nativity differences in HPV awareness and knowledge, and awareness of HPV vaccination using data from a population-based sample of adults in the U.S. (n = 2415). Among foreign-born respondents, we also assessed the association of acculturation with outcomes. Awareness of HPV and HPV vaccination were lower among foreign-born respondents compared to U.S.-born respondents. Knowledge of HPV was similar between populations. Acculturation was not associated with any of the assessed outcomes. Findings suggest HPV-related awareness deficits among foreign-born U.S. residents, highlighting a need for culturally-appropriate HPV prevention efforts.
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Affiliation(s)
- Manami Bhattacharya
- Department of Health Management and Policy, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Serena Xiong
- Department of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Annie-Laurie McRee
- Department of Pediatrics, University of Minnesota Medical School, 717 Delaware St SE #386, Minneapolis, MN, 55414, USA.
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Nagao-Sato S, Druziako S, Baltaci A, Peralta Reyes AO, Zhang Y, Hurtado Choque GA, Reicks M. Differences in reporting food insecurity and factors associated with differences among Latino fathers and mothers. BMC Public Health 2021; 21:912. [PMID: 33985468 PMCID: PMC8117496 DOI: 10.1186/s12889-021-10971-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 04/30/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Food security status has been assessed as a representative score for households; however, different members in the same household may perceive and report food insecurity differently. A high prevalence of food insecurity has been reported among Latino households, therefore understanding differences in reporting food insecurity by Latino father-mother dyads may improve accuracy of assessment and plans to address food insecurity. This study aimed to 1) determine demographic characteristics and/or food-related factors associated with perceptions of food security status among Latino father-mother dyads, and 2) identify factors associated with discordance in perceptions of food insecurity between dyads. METHODS Baseline data were used from a community-based, youth obesity prevention program among Latino families (n = 106 father-mother dyads). Food security was assessed with a 2-item food insecurity screen. Logistic regression models were used to evaluate associations between reporting food security status and predictor variables for fathers, mothers, and dyad-discordant responses. RESULTS Food insecurity was reported by 39% of fathers and 55% of mothers. Adjusted odds of reporting food insecurity were significantly higher for fathers perceiving their neighborhood was unsafe vs. safe (OR: 3.7, p < 0.05) and reporting lower vs. higher household income (OR: 3.2, p < 0.05). Adjusted odds of reporting food insecurity were significantly higher for mothers perceiving their neighborhood was unsafe vs. safe (OR: 4.1, p < 0.01) and reporting lower vs. higher home availability of fruit and vegetable (OR: 5.5, p < 0.01). Dyad discordance in reporting food security status occurred in 24% of the dyads. Adjusted odds of dyad discordant reports of food insecurity status were significantly higher for dyads reporting discordant responses regarding previous nutrition education (OR: 3.4, p < 0.05) and higher home fruit and vegetable accessibility (OR: 3.1, p < 0.05) compared to dyads reporting concordant responses. Among the 28 dyads who reported discordant nutrition education participation, 21 reported that fathers had never participated but mothers had participated more than once. CONCLUSIONS Differential factors were associated with reporting food security among Latino father-mother dyads. Nutrition education for fathers that improves awareness of home food supplies and a better understanding of how food accessibility influences maternal perceptions may improve dyad discordance in reporting household food security.
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Affiliation(s)
- Sayaka Nagao-Sato
- Department of Food Science and Nutrition, University of Minnesota, 1334 Eckles Ave., St. Paul, MN, 55304, USA.
| | - Stephanie Druziako
- Department of Food Science and Nutrition, University of Minnesota, 1334 Eckles Ave., St. Paul, MN, 55304, USA
| | - Aysegul Baltaci
- Department of Food Science and Nutrition, University of Minnesota, 1334 Eckles Ave., St. Paul, MN, 55304, USA
| | | | - Youjie Zhang
- Department of Child and Adolescent Health and Social Medicine, School of Public Health, Medical College of Soochow University, 199 Ren Ai Road, Jiangsu, 215123, Suzhou, China
| | | | - Marla Reicks
- Department of Food Science and Nutrition, University of Minnesota, 1334 Eckles Ave., St. Paul, MN, 55304, USA
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Nagao-Sato S, Baltaci A, Peralta Reyes AO, Zhang Y, Hurtado Choque GA, Reicks M. Skin Carotenoid Scores Assessed with Reflection Spectroscopy Are Associated with Self-Reported Fruit and Vegetable Intake Among Latino Early Adolescents. J Acad Nutr Diet 2021; 121:1507-1514. [PMID: 33820748 DOI: 10.1016/j.jand.2021.02.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 02/15/2021] [Accepted: 02/17/2021] [Indexed: 01/27/2023]
Abstract
BACKGROUND Latino early adolescents have a high prevalence of overweight and obesity. Interventions to address healthy eating among Latino youth frequently focus on fruit and vegetable (FV) intake. Reflection spectroscopy assessed skin carotenoid (SC) levels has been proposed as an easy, noninvasive method to evaluate FV intake, but validation studies involving ethnically diverse youth are lacking. OBJECTIVE This study aimed to assess the association between reflection spectroscopy-measured SC scores and self-reported FV intake among low-income, urban, Latino early adolescents, controlling for potential confounding factors. DESIGN This study was a cross-sectional secondary analysis of baseline data from a community-based intervention program (Padres Preparados, Jóvenes Saludables) involving Latino fathers and adolescents to improve paternal parenting practices and youth energy balance-related behaviors. PARTICIPANTS/SETTING Participants were 195 low-income, Latino early adolescents (aged 10 to 14 years). Data were collected in the Minneapolis/St Paul metropolitan area from 2017 to 2020 during fall or winter months. MAIN OUTCOME MEASURES SC scores were measured using reflection spectroscopy, usual intakes of FV and carotenoid compounds were estimated based on the assessment using 24-hour dietary recalls. STATISTICAL ANALYSIS Multivariable linear regression analyses were used to estimate associations of SC scores and each dietary component and potential confounding factors after assessing variables for inclusion in the analyses. RESULTS The mean SC score was 225 ± 95. The mean FV and total carotenoid intakes were 3.3 ± 0.5 servings/day and 8,360 ± 786 μg/day, respectively. Higher SC scores were observed among youth who had higher FV (β = .37 and P < 0.01) or total carotenoid intakes (β = .31 and P < 0.01). SC scores measured during fall were higher than scores measured during winter. Study participants with higher home FV availability and accessibility had higher SC scores. CONCLUSIONS Findings supported using SC score as a potential easy-to-use indicator of FV intake among Latino youth with consideration of seasonal variation and home FV availability and accessibility.
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Bilal PI, Chan CKY, Somerset SM. Acculturation and Perceived Ethnic Discrimination Predict Elevated Blood Glucose Level in Sub-Saharan African Immigrants in Australia. J Immigr Minor Health 2021; 22:771-777. [PMID: 31845072 DOI: 10.1007/s10903-019-00958-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Sub-Saharan African migrants experience significant sociocultural challenges, including those related to acculturation and perceived ethnic discrimination (PED), in addition to increased risk of non-communicable diseases, such as type 2 diabetes mellitus (T2DM). Although acculturation and PED are each established risk factors for elevated blood glucose level (EGBL) and T2DM, they have not been studied in relation to EBGL risk in a single model. This study aimed to investigate associations between acculturation, PED and EBGL in a sub-Saharan African migrant population in Australia. Face to face survey using a purposive sampling method was used to collect data from 170 adults, aged 18-72 years. A large proportion (41.8%) of the study group was in the integration mode of acculturation, which strongly correlated positively with EBGL/T2DM, although traditional mode correlated inversely with EBGL/T2DM. PED correlated positively with EBG/LT2DM. Immigrants manifesting the integration mode were 4.2 times more likely to have EBGL/T2DM than other acculturation modes. Multiple linear regression showed that the association between integration mode and EBGL/T2DM was mediated by PED. The apparent interaction between PED and acculturation in relation to EBGL/T2DM risk suggests that interventions to lower T2DM risk in this population may benefit from incorporating strategies to address these two important health determinants.
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Affiliation(s)
- P I Bilal
- School of Allied Health, Faculty of Health Sciences, Australian Catholic University, Brisbane, Australia.
| | - C K Y Chan
- School of Psychology and Public Health, College of Science, Health and Engineering, La Trobe University, Melbourne, Australia
| | - S M Somerset
- Faculty of Health, University of Canberra, Bruce, Australia
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Wang VA, Chu MT, Chie L, Gaston SA, Jackson CL, Newendorp N, Uretsky E, Dodson RE, Adamkiewicz G, James-Todd T. Acculturation and endocrine disrupting chemical-associated personal care product use among US-based foreign-born Chinese women of reproductive age. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2021; 31:224-232. [PMID: 33235331 PMCID: PMC7954893 DOI: 10.1038/s41370-020-00279-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 10/20/2020] [Accepted: 11/05/2020] [Indexed: 05/18/2023]
Abstract
BACKGROUND Personal care products (PCPs) are an important source of endocrine disrupting chemicals (EDCs) linked to adverse reproductive health outcomes. OBJECTIVE We evaluated EDC-associated PCP use and acculturation among Asian women. METHODS Our study included 227 foreign-born Chinese women ages 18-45 seeking obstetrics-gynecology care at community health centers (Boston, MA). Acculturation was measured by English-language use, length of US residence, and age at US entry. Self-reported use of PCPs (crème rinse/conditioner, shampoo, perfume/cologne, bar soap/body wash, liquid hand soap, moisturizer/lotion, colored cosmetics, sunscreen, and nail polish) in the last 48 h was collected. Latent class analysis was used to identify usage patterns. We also conducted multivariable logistic to determine the cross-sectional associations of acculturation measures and the use of individual PCP types. RESULTS Those who used more PCP types, overall and by each type, tended to be more acculturated. Women who could speak English had 2.77 (95% CI: 1.10-7.76) times the odds of being high PCP users compared to their non-English speaking counterparts. English-language use was associated with higher odds of using perfume/cologne and nail polish. SIGNIFICANCE Our findings give insight about EDC-associated PCP use based on acculturation status, which can contribute to changes in immigrant health and health disparities.
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Affiliation(s)
- Veronica A Wang
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - MyDzung T Chu
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Lucy Chie
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, 02215, USA
| | - Symielle A Gaston
- Department of Health and Human Services, Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, 27709, USA
| | - Chandra L Jackson
- Department of Health and Human Services, Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, 27709, USA
- Department of Health and Human Services, Intramural Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Nicole Newendorp
- Committee on Degrees in Social Studies, Harvard University, Cambridge, MA, 02138, USA
| | - Elanah Uretsky
- Department of Anthropology, Brandeis University, Waltham, MA, 02453, USA
| | | | - Gary Adamkiewicz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Tamarra James-Todd
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA.
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, 02114, USA.
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Lee JR, Maruthur NM, Yeh HC. Nativity and prevalence of cardiometabolic diseases among U.S. Asian immigrants. J Diabetes Complications 2020; 34:107679. [PMID: 32900593 PMCID: PMC9078065 DOI: 10.1016/j.jdiacomp.2020.107679] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 07/08/2020] [Accepted: 07/13/2020] [Indexed: 11/17/2022]
Abstract
AIMS Acculturation has been shown to be an important factor for immigrants' health in the United States. We investigate whether nativity is associated with a greater risk for cardiometabolic diseases among Asian Americans (Asians) vs. non-Hispanic whites (whites). METHODS Based on data from the U.S. National Health Interview Survey in 2006-2015, 146,862 Asians and whites aged ≥30 years were evaluated. Nativity as a proxy for acculturation was defined using a combination of birthplace and the duration of U.S. residency. Cardiometabolic diseases were defined based on self-reported diagnoses of diabetes, prediabetes, or cardiovascular diseases (CVD). Using 10-year pooled data accounting for complex sampling designs and weights, multiple logistic regression models were used to assess associations. Four Asian subgroups, including Chinese, Filipinos, Asian Indians and other Asians, were evaluated in subgroup analyses. RESULTS Compared to U.S.-born whites, prevalent type 2 diabetes and prediabetes were higher among Asians depending on nativity. However, the prevalence of CVD was lower among Asians than among whites regardless of nativity (OR≥15 years = 0.5 [95% CI:0.5-0.6], ORU.S-born = 0.7 [95% CI:0.6-0.8]). In addition, compared to U.S.-born whites, prevalent type 2 diabetes and prediabetes increased with an increasing length of U.S. residency for foreign-born Asians among Asians overall (≥15 years: ORdiabetes = 1.5 [95% CI:1.3-1.7]; ORprediabetes = 1.3 [95% CI:1.2-1.6]) and Asian Indians and Filipinos. Furthermore, a significant graded association between prediabetes and length of U.S. residency was found among foreign-born Asians. CONCLUSIONS The prevalence of diabetes and prediabetes is higher among Asian immigrants who have spent more years in the U.S., than those in U.S.-born whites. Monitoring and prevention efforts for diabetes should target this group.
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Affiliation(s)
- Jiwon R Lee
- Samsung Health Research Institute, Samsung Electronics Co., Ltd., Hwaseong 18448, Republic of Korea.
| | - Nisa M Maruthur
- Department of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA; Department of Epidemiology, Johns Hopkins University, Baltimore, MD 21205, USA.
| | - Hsin-Chieh Yeh
- Department of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA; Department of Epidemiology, Johns Hopkins University, Baltimore, MD 21205, USA.
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Yoshida Y, Broyles S, Scribner R, Chen L, Phillippi S, Jackson-Thompson J, Simoes EJ, Tseng TS. Social support modifies the negative effects of acculturation on obesity and central obesity in Mexican men. ETHNICITY & HEALTH 2020; 25:1103-1114. [PMID: 29944431 PMCID: PMC9044708 DOI: 10.1080/13557858.2018.1492708] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 06/11/2018] [Indexed: 06/08/2023]
Abstract
Background: This study examined the moderating role of social support in the acculturation-obesity/central obesity relationship in Mexican American (MA) men and women. Methods: Data from NHANES 1999-2008 were used. Acculturation derived from language use, country of birth and length of residence in the U.S. Social support assessed emotional and financial support. BMI (≥30) and waist circumference (≥88 cm for women; ≥102 cm for men) measured obesity and central obesity, respectively. Weighted multivariate logistic regression models were used to describe associations. Results: Compared to less acculturation, more acculturation was associated with higher odds of obesity (ORs 2.48; 95% CI 1.06-5.83) and central obesity (2.90; 1.39-6.08) among MA men with low/no social support, but not among MA men reporting high social support. The modifying effects was not observed among women. Conclusion: Higher amounts of social support appeared to attenuate the risk of obesity/central obesity associated with acculturation. Interventions enhancing social support maybe effective among acculturated MAs, particularly among men.
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Affiliation(s)
- Yilin Yoshida
- Department of Health Management and Informatics, School of Medicine, University of Missouri, CE707 CS&E Bldg., One Hospital Drive, Columbia, Missouri 65212
- Missouri Cancer Registry & Research Center, 401 Clark Hall, Columbia, Missouri 65211
| | - Stephanie Broyles
- Behavioral and Community Health Sciences program, School of Public Health, Louisiana State University Health Sciences Center, 3FL, 2020 Gravier St., New Orleans, Louisiana 70112
- Pennington Biomedical Research Center, Baton Rouge, Louisiana
| | - Richard Scribner
- Epidemiology program, School of Public Health, Louisiana State University Health Sciences Center, 3FL, 2020 Gravier St., New Orleans, Louisiana 70112
| | - Liwei Chen
- Department of Public Health Sciences, Clemson University, 503 Edwards Hall, Clemson, SC 29634-0745
| | - Stephen Phillippi
- Behavioral and Community Health Sciences program, School of Public Health, Louisiana State University Health Sciences Center, 3FL, 2020 Gravier St., New Orleans, Louisiana 70112
| | - Jeanette Jackson-Thompson
- Department of Health Management and Informatics, School of Medicine, University of Missouri, CE707 CS&E Bldg., One Hospital Drive, Columbia, Missouri 65212
- Missouri Cancer Registry & Research Center, 401 Clark Hall, Columbia, Missouri 65211
| | - Eduardo J. Simoes
- Department of Health Management and Informatics, School of Medicine, University of Missouri, CE707 CS&E Bldg., One Hospital Drive, Columbia, Missouri 65212
| | - Tung-Sung Tseng
- Behavioral and Community Health Sciences program, School of Public Health, Louisiana State University Health Sciences Center, 3FL, 2020 Gravier St., New Orleans, Louisiana 70112
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Colorectal Cancer-Related Knowledge, Acculturation, and Healthy Lifestyle Behaviors Among Low-Income Vietnamese Americans in the Greater Philadelphia Metropolitan Area. J Community Health 2020; 45:1178-1186. [PMID: 33026553 DOI: 10.1007/s10900-020-00931-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2020] [Indexed: 10/23/2022]
Abstract
Colorectal cancer (CRC) is the second and fourth most common cancer in Vietnamese American women and men, respectively. Recent research has highlighted the importance of modifiable lifestyle behaviors such as smoking, alcohol use, dietary behaviors, and physical activities in CRC prevention for the general population. However, it is not well understood how well Vietnamese Americans knew about CRC prevention and risk factors, and whether there were any disparities in knowledge within this vulnerable population. This study examined whether comprehensive measures of acculturation and knowledge of CRC risk are associated with different health behaviors, specifically physical activity, protective dietary behaviors, and risky dietary behaviors in Vietnamese Americans. We recruited 374 Vietnamese Americans aged 50 or above from community-based organizations in the Vietnamese American communities in the greater Philadelphia metropolitan area. Through a cross-sectional survey, we collected data on their knowledge of CRC prevention and risk factors, acculturation-related factors, and sociodemographic characteristics. We found limited knowledge of CRC prevention and risk factors, and suboptimal physical activity and healthy dietary behaviors in the Vietnamese Americans. We also found that higher levels of knowledge about CRC and risk factors were associated with less unhealthy diets but not with more protective diets or physical activity. Acculturation was not significantly associated with overall dietary behaviors in our study. Our findings addressed gaps in current literature concerning the impact of knowledge about CRC risk factors and acculturation on different dimensions of dietary behaviors as well as physical activity. Research and practical implications were discussed.
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Ngueta G. Lifetime Average Cannabis Use in Relation to Hypertriglyceridemic Waist Phenotype in U.S. Adults: A Population-Based Cross-Sectional Study. Cannabis Cannabinoid Res 2020; 5:246-254. [PMID: 32923661 DOI: 10.1089/can.2019.0048] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Background and Aims: With a growing number of states legalizing recreational or medical cannabis, prevalence of cannabis users is expected to markedly increase in the future. We aim to determine the association between lifetime cannabis use and the likelihood for hypertriglyceridemic waist (HTGW+/+) phenotype in U.S. adults. Methods: We abstracted data from the National Health and Nutrition Examination Survey from 2009 to 2016. We estimated the minimal lifetime cannabis use using the duration of regular exposure and the frequency of use. Outcomes were HTGW+/+ phenotype, defined as being waist circumference >90 cm (for men) or 85 cm (for women), and serum fasting triglycerides ≥177 mg/dL. We used multiple logistic regression models to estimate the adjusted odds ratio (AOR) and 95% confidence intervals (CIs). Results: Of the 47,364 adults included, 48.5% were women. The prevalence of HTGW+/+ phenotype was 11.7%. Current, but not former, users were less likely to show HTGW+/+ phenotype. Current cannabis users with greater or equal to four uses per week showed a significant lower likelihood for HTGW+/+ than those who never used cannabis (AOR 0.46 [95% CI, 0.22-0.97]). HTGW+/+ phenotype was associated with neither two to three uses per week (AOR 1.12 [95% CI, 0.40-3.12]) nor less than two uses per week (AOR 0.56 [95% CI, 0.18-1.73]). Conclusions: Average lifetime frequency of greater or equal to four cannabis uses per week is linked to lower odds of HTGW+/+ in current users. Former use is not associated with HTGW+/+.
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Affiliation(s)
- Gerard Ngueta
- Centre de recherche sur les soins et les services de première ligne de l'Université Laval (CERSSPL-UL), Quebec (Quebec), Canada.,Department of Social and Preventive Medicine, Faculty of Medicine, Laval University, Quebec (Quebec), Canada
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Bonilla-Escobar BA, Borrell LN, Del Cura-González I, Sánchez-Perruca L, Escortell-Mayor E, Franco M. Type 2 diabetes prevalence among Andean immigrants and natives in a Southern European City. Acta Diabetol 2020; 57:1065-1072. [PMID: 32253608 DOI: 10.1007/s00592-020-01515-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 03/07/2020] [Indexed: 11/24/2022]
Abstract
AIMS Inequalities in diabetes prevalence among immigrants from Andean countries remain unknown. Andean populations are one of the largest groups of immigrants in Madrid city. We examined the association between country of birth and type 2 diabetes mellitus (T2DM) prevalence in Andean immigrant population relative to Spanish-natives; and whether this association varied by age, sex and length of residence. METHODS We analyzed 1,258,931 electronic medical records from Spanish native and Andean immigrant adults aged 40-75 years of Madrid city. We used logistic regression and test interaction terms to address our aims. RESULTS Andean immigrants showed 1.13 (95% CI 1.10-1.17) greater adjusted odds for T2DM than Spanish natives. This association was positive in Ecuadorians and Bolivians but protective in Peruvians and Colombians. There was heterogeneity of this association according to age and sex. Relative to Spanish natives, odds of T2DM in Andeans of all ages and women were higher but lower in men. CONCLUSION Andean adults showed greater odds of T2DM compared with Spanish native adults in Madrid, with variation observed by age and sex. These findings emphasize the need for studying immigrant populations in a disaggregated manner to implement specific clinical and preventive approaches.
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Affiliation(s)
- Bertha Angelica Bonilla-Escobar
- Social and Cardiovascular Epidemiology Research Group, School of Medicine, University of Alcala, Alcala de Henares, Madrid, Spain
| | - Luisa N Borrell
- Social and Cardiovascular Epidemiology Research Group, School of Medicine, University of Alcala, Alcala de Henares, Madrid, Spain.
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, The City University of New York, 55 West 125th Street, 530, New York, NY, 10027, USA.
| | - Isabel Del Cura-González
- Research Unit, Assistance Office for Primary Care, Health Services of Madrid, Madrid, Spain
- Department of Preventive Medicine and Public Health, University Rey Juan Carlos, Madrid, Spain
- Health Services Research on Chronic Patients Network (REDISSEC), Institute of Health Carlos III, ISCIII, Madrid, Spain
| | - Luis Sánchez-Perruca
- Health Services Research on Chronic Patients Network (REDISSEC), Institute of Health Carlos III, ISCIII, Madrid, Spain
- Information Technology Systems, Assistance Office for Primary Care, Health Services of Madrid, Madrid, Spain
| | - Esperanza Escortell-Mayor
- Research Unit, Assistance Office for Primary Care, Health Services of Madrid, Madrid, Spain
- Health Services Research on Chronic Patients Network (REDISSEC), Institute of Health Carlos III, ISCIII, Madrid, Spain
| | - Manuel Franco
- Social and Cardiovascular Epidemiology Research Group, School of Medicine, University of Alcala, Alcala de Henares, Madrid, Spain
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, The City University of New York, 55 West 125th Street, 530, New York, NY, 10027, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Kwon S, Wang-Schweig M, Kandula NR. Body Composition, Physical Activity, and Convenience Food Consumption among Asian American Youth: 2011-2018 NHANES. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E6187. [PMID: 32858944 PMCID: PMC7504455 DOI: 10.3390/ijerph17176187] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 08/20/2020] [Accepted: 08/21/2020] [Indexed: 12/20/2022]
Abstract
The primary purpose of this study was to describe obesity, body composition, convenience food consumption, physical activity, and muscle strength among Asian American youth compared to other racial/ethnic groups. The secondary purpose was to examine whether obesity, body composition, convenience food consumption, physical activity, and muscle strength differed by acculturation levels among Asian American youth. A secondary analysis was conducted using data from 12,763 children aged 2 to 17 years that participated in the 2011-2018 US National Health and Nutrition Examination Survey (NHANES). In the NHANES interview, acculturation, dietary behavior, and physical activity questionnaires were administered. The acculturation level was indicated by the language spoken at home. In the NHANES examination, anthropometry, dual-energy X-ray absorptiometry (DXA), and muscle strength assessments were conducted. Compared to non-Hispanic White American boys, Asian American boys had similar levels of obesity, central obesity, and fat mass. Among the five racial/ethnic groups examined, lean body mass, muscle mass, convenience food consumption, and daily physical activity were the lowest in the Asian group. More acculturated Asian American boys, but not girls, were more likely to be obese (OR = 3.28 (1.63, 6.60)). More acculturated Asian American youth more frequently consumed convenience food (1.4 more meals/month (1.2, 1.6)). This study highlights the obesity problem among Asian American boys, which worsens with acculturation to America. The study results also suggest that although Asian American youth consume less convenience food overall than non-Hispanic White American youth, increasing acculturation may negatively influence food choices.
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Affiliation(s)
- Soyang Kwon
- Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL 60611, USA
| | - Meme Wang-Schweig
- Division of Community Health Sciences, University of Illinois Chicago School of Public Health, Chicago, IL 60607, USA;
| | - Namratha R. Kandula
- Department of Medicine and Preventive Medicine, Northwestern University, Chicago, IL 60611, USA;
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