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Parra-Soto S, Araya C, Knight K, Livingstone KM, Malcomson FC, Sharp L, Mathers JC, Ho FK, Celis-Morales C, Pell JP. Different Sources of Fiber Intake and Risk of 17 Specific Cancers and All Cancers Combined: Prospective Study of 364,856 Participants in the UK Biobank. Am J Epidemiol 2024; 193:660-672. [PMID: 37855261 DOI: 10.1093/aje/kwad202] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 02/15/2023] [Accepted: 10/06/2023] [Indexed: 10/20/2023] Open
Abstract
Inverse associations between dietary fiber (DF) and colorectal cancer risk are well-established. However, evidence is limited in relation to other cancer sites. This study, of 364,856 participants from the UK Biobank, aimed to evaluate the associations between total and source-specific partial DF and risk of 17 specific cancers and all cancers combined. Partial DF was derived from baseline touchscreen questionnaire data on cereal, bread, fruit, and vegetable intake. The outcomes were incident cancer at 17 sites and all cancers combined. Cox proportional hazards models were applied. Over a median 8.8-year follow-up period, 30,725 people were diagnosed with cancer. After adjusting for sociodemographic and lifestyle factors, those in the highest quintile of partial DF compared with the lowest quintile (<9.6 vs ≥19.1 g/day) had 10% lower risk of cancer overall, with the greatest risk reductions observed for cervical (hazard ratio (HR) = 0.33, 95% confidence interval (CI): 0.14; 0.82), esophageal (HR = 0.66, 95% CI: 0.52; 0.84), lung (HR = 0.67, 95% CI: 0.59; 0.76), bladder (HR = 0.72, 95% CI: 0.56; 0.91), and kidney (HR = 0.75, 95% CI: 0.61; 0.92) cancers. Associations between DF and lung cancer were observed only in current and former smokers. Higher DF intake, in particular cereal fiber and fruit and vegetable fiber, was associated with a lower risk of overall and multiple site-specific cancers.
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Cabanas-Sánchez V, Duarte Junior MA, Lavie CJ, Celis-Morales C, Rodríguez-Artalejo F, Martínez-Gómez D. Physical Activity and Cause-Specific Cardiovascular Mortality Among People With and Without Cardiovascular Disease: A Cohort Study of 0.6 Million US Adults. Mayo Clin Proc 2024; 99:564-577. [PMID: 37676199 DOI: 10.1016/j.mayocp.2023.05.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 05/17/2023] [Indexed: 09/08/2023]
Abstract
OBJECTIVE To assess the association of physical activity (PA) with cause-specific cardiovascular disease (CVD) mortality among people with preexisting CVD and to analyze the relationship of PA with CVD-related mortality in people without CVD as well as the association of PA with nonspecific CVD mortality in both populations. PARTICIPANTS AND METHODS Of the total participants in the 1997 through 2018 US National Health Interview Survey waves, 87,959 adults with CVD and 527,185 without CVD were included. Leisure-time PA was self-reported; based on frequency and duration, minutes per week in PA were calculated and subsequently classified into: (1) none: 0 min/wk, (2) insufficient: 1 to 149.9 min/wk, (3) recommended: 150 to 300 min/wk, and (4) additional: more than 300 min/wk. Mortality data were obtained through link to records from the National Death Index. Statistical analyses were performed with Cox regression adjusted for potential confounders. RESULTS During a mean follow-up of 8.5 years, 12,893 participants with CVD, 9943 with coronary heart disease (CHD), and 843 with stroke died of CVD mortality, diseases of heart mortality, and cerebrovascular mortality, respectively. In fully adjusted models, compared with no PA, insufficient, recommended, and additional PA were associated with 25.9%, 37.1%, and 42.0% lower risk of diseases of heart mortality among people with prior CHD, respectively. Among people with stroke, recommended and additional PA was related to 30.7% and 59.3% lower risk of cerebrovascular mortality, respectively. The protective effect of PA on cause-specific CVD mortality was greater in people with CVD than in those without prior CVD. Moreover, PA was more markedly inversely associated with cause-specific CVD mortality than with nonspecific CVD mortality in people with CVD. CONCLUSION Physical activity was strongly associated with lower risk of CVD-, CHD-, and stroke-related mortality among people with a history of these specific diseases. Health care professionals should emphasize the importance of a physically active lifestyle in patients with CVD.
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Affiliation(s)
- Verónica Cabanas-Sánchez
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Calle del Arzobispo Morcillo, 4, 28029, Madrid, Spain; CIBERESP (CIBER of Epidemiology and Public Health), Av. Monforte de Lemos, 3-5, 28029, Madrid, Spain; IMDEA-Food Institute, CEI UAM+CSIC, Ctra. de Canto Blanco 8, E. 28049, Madrid, Spain.
| | - Miguel Angelo Duarte Junior
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Calle del Arzobispo Morcillo, 4, 28029, Madrid, Spain
| | - Carl J Lavie
- Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans, LA
| | - Carlos Celis-Morales
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK G12 8TA; Human Performance Lab, Education, Physical Activity and Health Research Unit, University Católica del Maule, Talca, 3466706, Chile
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Calle del Arzobispo Morcillo, 4, 28029, Madrid, Spain; CIBERESP (CIBER of Epidemiology and Public Health), Av. Monforte de Lemos, 3-5, 28029, Madrid, Spain; IMDEA-Food Institute, CEI UAM+CSIC, Ctra. de Canto Blanco 8, E. 28049, Madrid, Spain
| | - David Martínez-Gómez
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Calle del Arzobispo Morcillo, 4, 28029, Madrid, Spain; CIBERESP (CIBER of Epidemiology and Public Health), Av. Monforte de Lemos, 3-5, 28029, Madrid, Spain; IMDEA-Food Institute, CEI UAM+CSIC, Ctra. de Canto Blanco 8, E. 28049, Madrid, Spain
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Petermann-Rocha F, Carrasco-Marin F, Boonpor J, Parra-Soto S, Shannon O, Malcomson F, Phillips N, Jain M, Deo S, Livingstone KM, Dingle SE, Mathers JC, Forrest E, Ho FK, Pell JP, Celis-Morales C. Association of five diet scores with severe NAFLD incidence: A prospective study from UK Biobank. Diabetes Obes Metab 2024; 26:860-870. [PMID: 37997550 DOI: 10.1111/dom.15378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 10/26/2023] [Accepted: 11/05/2023] [Indexed: 11/25/2023]
Abstract
AIM This study aimed to contrast the associations of five common diet scores with severe non-alcoholic fatty liver disease (NAFLD) incidence. MATERIALS AND METHODS In total, 162 999 UK Biobank participants were included in this prospective population-based study. Five international diet scores were included: the 14-Item Mediterranean Diet Adherence Screener (MEDAS-14), the Recommended Food Score (RFS), the Healthy Diet Indicator (HDI), the Mediterranean Diet Score and the Mediterranean-DASH Intervention for Neurodegenerative Delay score. As each score has different measurements and scales, all scores were standardized and categorized into quartiles. Cox proportional hazard models adjusted for confounder factors investigated associations between the standardized quartiles and severe NAFLD incidence. RESULTS Over a median follow-up of 10.2 years, 1370 participants were diagnosed with severe NAFLD. When the analyses were fully adjusted, participants in quartile 4 using the MEDAS-14 and RFS scores, as well as those in quartiles 2 and 3 using the HDI score, had a significantly lower risk of severe incident NAFLD compared with those in quartile 1. The lowest risk was observed in quartile 4 for the MEDAS-14 score [hazard ratio (HR): 0.76 (95% confidence interval (CI): 0.62-0.94)] and the RFS score [HR: 0.82 (95% CI: 0.69-0.96)] and as well as in quartile 2 in the HDI score [HR: 0.80 (95% CI: 0.70-0.91)]. CONCLUSION MEDAS-14, RFS and HDI scores were the strongest diet score predictors of severe NAFLD. A healthy diet might protect against NAFLD development irrespective of the specific approach used to assess diet. However, following these score recommendations could represent optimal dietary approaches to mitigate NAFLD risk.
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Affiliation(s)
- Fanny Petermann-Rocha
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
- Centro de Investigación Biomédica, Facultad de Medicina, Universidad Diego Portales, Santiago, Chile
| | - Fernanda Carrasco-Marin
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
- Centro de Vida Saludable, Universidad de Concepción, Concepción, Chile
| | - Jirapitcha Boonpor
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
- Faculty of Public Health, Kasetsart University, Chalermphrakiat Sakon Nakhon Province Campus, Kasetsart University, Sakon Nakhon, Thailand
| | - Solange Parra-Soto
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
- Department of Nutrition and Public Health, Universidad del Bío-Bío, Chillán, Chile
| | - Oliver Shannon
- Human Nutrition & Exercise Research Centre, Centre for Healthier Lives, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Fiona Malcomson
- Human Nutrition & Exercise Research Centre, Centre for Healthier Lives, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Nathan Phillips
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
| | - Mahek Jain
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
| | - Salil Deo
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
- Surgical Services, Louis Stokes Cleveland VA Medical Center, Cleveland, Ohio, USA
- Case School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - Katherine M Livingstone
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Sara E Dingle
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - John C Mathers
- Human Nutrition & Exercise Research Centre, Centre for Healthier Lives, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Ewan Forrest
- Department of Gastroenterology, Glasgow Royal Infirmary, University of Glasgow, Glasgow, UK
| | - Frederick K Ho
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Jill P Pell
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Carlos Celis-Morales
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
- Human Performance Laboratory, Education, Physical Activity and Health Research Unit, Universidad Católica del Maule, Talca, Chile
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Malcomson FC, Parra-Soto S, Lu L, Ho F, Celis-Morales C, Sharp L, Mathers JC. Socio-demographic variation in adherence to the World Cancer Research Fund (WCRF)/American Institute for Cancer Research (AICR) Cancer Prevention Recommendations within the UK Biobank prospective cohort study. J Public Health (Oxf) 2024; 46:61-71. [PMID: 37986550 PMCID: PMC10901269 DOI: 10.1093/pubmed/fdad218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 08/22/2023] [Accepted: 10/15/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND The 2018 (WCRF)/American Institute for Cancer Research (AICR) Cancer Prevention Recommendations are evidence-based lifestyle recommendations which aim to reduce the risk of cancer worldwide. Sociodemographic factors modulate lifestyle behaviours, and both cancer incidence and survival are socio-economically patterned. We investigated adherence to these recommendations and examined patterns of adherence across sociodemographic subgroups in the UK Biobank cohort. METHODS We included 158 415 UK Biobank participants (mean age 56 years, 53% female). Total adherence scores were derived from dietary, physical activity and anthropometric data using the 2018 WCRF/AICR standardized scoring system. One-Way analysis of variance (ANOVA) was used to test for differences in total scores and in values for individual score components according to sociodemographic factors and Pearson's Χ2 test to investigate associations between sociodemographic factors according to tertiles of adherence score. RESULTS Mean total adherence score was 3.85 points (SD 1.05, range 0-7 points). Higher total scores were observed in females, and older (>57 years), Chinese or South Asian, and more educated participants. We found significant variations in adherence to individual recommendations by sociodemographic factors including education, Townsend deprivation index and ethnicity. CONCLUSIONS Identifying and understanding lifestyle and dietary patterns according to sociodemographic factors could help to guide public health strategies for the prevention of cancers and other non-communicable diseases.
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Affiliation(s)
- Fiona C Malcomson
- Faculty of Medical Sciences, Human Nutrition & Exercise Research Centre, Centre for Healthier Lives, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
- Faculty of Medical Sciences, Centre for Cancer, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
| | - Solange Parra-Soto
- College of Medical, Veterinary and Life Sciences, School of Health and Wellbeing, University of Glasgow, Glasgow, G12 8TA, UK
- College of Medical, Veterinary and Life Sciences, School of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, G12 8TA, UK
- Department of Nutrition and Public Health, Universidad del Bío-Bío, Chillan, Chile
| | - Liya Lu
- Faculty of Medical Sciences, Centre for Cancer, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
| | - Frederick Ho
- College of Medical, Veterinary and Life Sciences, School of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, G12 8TA, UK
| | - Carlos Celis-Morales
- College of Medical, Veterinary and Life Sciences, School of Health and Wellbeing, University of Glasgow, Glasgow, G12 8TA, UK
- Human Performance Lab, Education, Physical Activity and Health Research Unit, University Católica del Maule, Talca, Chile
| | - Linda Sharp
- Faculty of Medical Sciences, Centre for Cancer, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
| | - John C Mathers
- Faculty of Medical Sciences, Human Nutrition & Exercise Research Centre, Centre for Healthier Lives, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
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Boonpor J, Pell JP, Ho FK, Celis-Morales C, Gray SR. In people with type 2 diabetes, sarcopenia is associated with the incidence of cardiovascular disease: A prospective cohort study from the UK Biobank. Diabetes Obes Metab 2024; 26:524-531. [PMID: 37881162 DOI: 10.1111/dom.15338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 09/22/2023] [Accepted: 10/04/2023] [Indexed: 10/27/2023]
Abstract
AIM To investigate the association of sarcopenia with cardiovascular disease (CVD) incidence in people with type 2 diabetes. MATERIALS AND METHODS A prospective cohort study with 11 974 White European UK Biobank participants with type 2 diabetes, aged 40-70 years, included. Sarcopenia was defined based on the European Working Group on Sarcopenia in Older People as either non-sarcopenic or sarcopenic. Outcomes included CVD, stroke, heart failure (HF) and myocardial infarction (MI). The association between sarcopenia and the incidence of outcomes was investigated using Cox proportional hazard models adjusted for sociodemographic and lifestyle factors. The rate advancement period was used to estimate the time period by which CVD is advanced because of sarcopenia. RESULTS Over a median follow-up of 10.7 years, 1957 participants developed CVDs: 373 had a stroke, 307 had an MI and 742 developed HF. Compared with non-sarcopenia, those with sarcopenia had higher risks of CVD (HR 1.89 [95% CI 1.61; 2.21]), HF (HR 2.59 [95% CI 2.12; 3.18]), stroke (HR 1.90 [95% CI 1.38; 2.63]), and MI (HR 1.56 [95% CI 1.04; 2.33]) after adjustment for all covariates. Those with sarcopenia had CVD incidence rates equivalent to those without sarcopenia who were 14.5 years older. Similar results were found for stroke, HF and MI. CONCLUSIONS In people with type 2 diabetes, sarcopenia increased the risk of developing CVD, which might occur earlier than in those without sarcopenia. Therefore, sarcopenia screening and prevention in patients with type 2 diabetes may be useful to prevent the complications of CVD.
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Affiliation(s)
- Jirapitcha Boonpor
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
- Faculty of Public Health, Chalermphrakiat Sakon Nakhon Province Campus, Kasetsart University, Sakon Nakhon, Thailand
| | - Jill P Pell
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Frederick K Ho
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Carlos Celis-Morales
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
- Human Performance Lab, Education, Physical Activity and Health Research Unit, University Católica del Maule, Talca, Chile
| | - Stuart R Gray
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
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Raisi A, Boonpor J, Breheny M, Vasquez J, Matus C, Diaz-Martinez X, Pell JP, Ho FK, Celis-Morales C. Association of Stair Use With Risk of Major Chronic Diseases. Am J Prev Med 2024; 66:324-332. [PMID: 37813170 DOI: 10.1016/j.amepre.2023.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 10/04/2023] [Accepted: 10/05/2023] [Indexed: 10/11/2023]
Abstract
INTRODUCTION Physical inactivity is associated with a higher risk of chronic diseases. Regular stair use can contribute to increasing physical activity in the population. This study aimed to investigate the association between flights of stairs used daily at home and all-cause mortality and cause-specific incidence and mortality. METHODS Of the 502,628 UK Biobank participants recruited between 2007 and 2010, 442,027 (mean age, 56±8 years) had available data and were included in the analyses conducted in 2023. Participants were categorized on the basis of flights of stairs climbed daily (1-5, 6-10, 11-15, >15). The disease-specific outcomes were cardiovascular disease, respiratory disease, cancer, type 2 diabetes, and all-cause dementia. Cox proportional hazard models, adjusted for sociodemographic, lifestyle, and health-related confounding factors, were used to analyze the associations between stair use frequency and health outcomes. RESULTS Participants were followed up for a median of 10.9 years. Climbing stairs >15 times per day was associated with a lower risk of 8 of the 9 outcomes analyzed than not using stairs. The magnitude of association ranged from 3% (95% CI=0.94, 0.99) lower risk for all-cause cancer to 51% (95% CI=0.39, 0.60) lower risk of chronic obstructive pulmonary disease. Findings were similar for mortality outcomes, with the hazard ratios ranging from 0.82 (95% CI=0.77, 0.87) for all-cause cancer to 0.46 (95% CI=0.23, 0.92) for chronic obstructive pulmonary disease mortality. CONCLUSIONS Stair use was associated with a lower risk of all-cause mortality and cause-specific incidence and mortality independent of confounding factors, including adiposity and multimorbidity.
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Affiliation(s)
- Andrea Raisi
- Center for Exercise Science and Sport, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy; School of Cardiovascular & Metabolic Health, University of Glasgow, Glasgow, United Kingdom
| | - Jirapitcha Boonpor
- School of Cardiovascular & Metabolic Health, University of Glasgow, Glasgow, United Kingdom; Faculty of Public Health, Chalermphrakiat Sakon Nakhon Province Campus, Kasetsart University, Sakon Nakhon, Thailand
| | - Megan Breheny
- School of Cardiovascular & Metabolic Health, University of Glasgow, Glasgow, United Kingdom
| | - Jaime Vasquez
- Laboratorio de Rendimiento Humano, Unidad de Investigación en Educación, Actividad Física y Salud. Universidad Católica del Maule. Talca, Chile
| | - Carlos Matus
- Department of Sports Sciences and Physical Conditioning, Faculty of Education, Universidad Católica de La Santísima Concepción, Concepción, Chile
| | - Ximena Diaz-Martinez
- Quality of Life Group in different populations, Department of Education Sciences, University of Bío-Bío, Chillan, Chile
| | - Jill P Pell
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Frederick K Ho
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Carlos Celis-Morales
- School of Cardiovascular & Metabolic Health, University of Glasgow, Glasgow, United Kingdom; Laboratorio de Rendimiento Humano, Unidad de Investigación en Educación, Actividad Física y Salud. Universidad Católica del Maule. Talca, Chile.
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Malcomson FC, Parra-Soto S, Ho FK, Celis-Morales C, Sharp L, Mathers JC. Abbreviated Score to Assess Adherence to the 2018 WCRF/AICR Cancer Prevention Recommendations and Risk of Cancer in the UK Biobank. Cancer Epidemiol Biomarkers Prev 2024; 33:33-42. [PMID: 37909916 PMCID: PMC10774737 DOI: 10.1158/1055-9965.epi-23-0923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 10/11/2023] [Accepted: 10/30/2023] [Indexed: 11/03/2023] Open
Abstract
BACKGROUND The World Cancer Research Fund (WCRF)/American Institute for Cancer Research (AICR) Cancer Prevention Recommendations are lifestyle-based guidelines which aim to reduce cancer risk. This study investigated, in the UK Biobank, associations between an abbreviated score to assess adherence to these Recommendations and the risk of all cancers combined and of 14 cancers for which there is strong evidence for links with diet, adiposity, and physical activity. METHODS We used data from 288,802 UK Biobank participants (mean age 56.2 years), cancer-free at baseline. An abbreviated version of the 2018 WCRF/AICR Score was calculated to assess adherence to five Recommendations on (i) body weight, (ii) physical activity, (iii) fruits, vegetables, and dietary fiber, (iv) red and processed meat, and (v) alcohol. Multivariable Cox proportional hazards models were used to analyze associations between the abbreviated score (range, 0-5 points) and cancer incidence, adjusting for confounders. RESULTS During a median follow-up of 8.2 years (interquartile range, 7.4-8.9), 23,448 participants were diagnosed with cancer. The abbreviated score was inversely associated with risk of cancer overall [HR: 0.93; 95% confidence interval (CI): 0.92-0.95 per 1-point increment], and breast (HR: 0.90; 95% CI: 0.87-0.94), colorectal (HR: 0.86; 95% CI: 0.83-0.90), lung (HR: 0.89; 95% CI: 0.84-0.94), kidney (HR: 0.83; 95% CI: 0.76-0.90), pancreatic (HR: 0.86; 95% CI: 0.79-0.94), uterine (HR: 0.79; 95% CI: 0.73-0.86), esophageal (HR: 0.82; 95% CI: 0.75-0.90), stomach (HR: 0.89; 95% CI: 0.79-0.99), and liver (HR: 0.80; 95% CI: 0.72-0.90) cancers. CONCLUSIONS Greater adherence to the Cancer Prevention Recommendations, assessed using an abbreviated score, was associated with reduced risk of all cancers combined and of nine site-specific cancers. IMPACT Our findings support compliance to these Recommendations for cancer prevention.
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Affiliation(s)
- Fiona C. Malcomson
- Human Nutrition & Exercise Research Centre, Centre for Healthier Lives, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
- Centre for Cancer, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Solange Parra-Soto
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
- School of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom
- Department of Nutrition and Public Health, Universidad del Bío-Bío, Chillan, Chile
| | - Frederick K. Ho
- School of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Carlos Celis-Morales
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
- School of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom
- Human Performance Lab, Education, Physical Activity and Health Research Unit, University Católica del Maule, Talca, Chile
| | - Linda Sharp
- Centre for Cancer, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - John C. Mathers
- Human Nutrition & Exercise Research Centre, Centre for Healthier Lives, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
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Diaz-Toro F, Nazzal Nazal C, Nazar G, Diaz-Martinez X, Concha-Cisternas Y, Celis-Morales C, Petermann-Rocha F. Association of Sitting Time With All-Cause and Cardiovascular Mortality: How Does Frailty Modify This Association? J Aging Phys Act 2023; 32:236-243. [PMID: 38134903 DOI: 10.1123/japa.2023-0105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 08/22/2023] [Accepted: 09/13/2023] [Indexed: 12/24/2023]
Abstract
To investigate how frailty modifies the association of sitting time with all-cause and cardiovascular mortality in Chilean adults. This prospective study included 2,604 participants aged ≥35 from the Chilean National Health Survey 2009-2010. Sitting time was self-reported, while frailty was assessed using a 36-item Frailty Index. Sitting time was categorized as low, medium, and high. Cox proportional hazard models were used to estimate the risk of mortality stratified for the sitting time categories. Over a median follow-up of 8.9 years, 311 participants died, 28% of them due to cardiovascular events. Frail people with prolonged sitting time were at higher risk of all-cause and cardiovascular mortality (hazard ratio 3.13; 95% confidence interval [2.06, 4.71] and hazard ratio 2.41; 95% confidence interval [1.50, 3.64], respectively). The observed risk was higher in women than men. Public health and individual strategies should be implemented to decrease sitting time across the population, with special attention on frail people.
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Affiliation(s)
- Felipe Diaz-Toro
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
- Facultad de Enfermería, Universidad Andres Bello, Santiago, Chile
| | - Carolina Nazzal Nazal
- Escuela de Salud Pública, Facultad de Medicina Universidad de Chile, Santiago, Chile
| | - Gabriela Nazar
- Departamento de Psicología y Centro de Vida Saludable, Universidad de Concepción, Concepción, Chile
| | | | - Yeny Concha-Cisternas
- Escuela de Kinesiología, Facultad de Salud, Universidad Santo Tomás, Talca, Chile
- Pedagogía en Educación Física, Facultad de Educación, Universidad Autónoma de Chile, Talca, Chile
| | - Carlos Celis-Morales
- Human Performance Lab, Education, Physical Activity and Health Research Unit, University Católica del Maule, Talca, Chile
| | - Fanny Petermann-Rocha
- Human Performance Lab, Education, Physical Activity and Health Research Unit, University Católica del Maule, Talca, Chile
- Centro de Investigación Biomédica, Facultad de Medicina, Universidad Diego Portales, Santiago, Chile
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Nazar G, Díaz-Toro F, Concha-Cisternas Y, Leiva-Ordoñez AM, Troncoso-Pantoja C, Celis-Morales C, Petermann-Rocha F. Latent class analyses of multimorbidity and all-cause mortality: A prospective study in Chilean adults. PLoS One 2023; 18:e0295958. [PMID: 38113219 PMCID: PMC10729966 DOI: 10.1371/journal.pone.0295958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 11/27/2023] [Indexed: 12/21/2023] Open
Abstract
Multimorbidity patterns can lead to differential risks for all-cause mortality. Within the Chilean context, research on morbidity and mortality predominantly emphasizes individual diseases or combinations thereof, rather than specific disease clusters. This study aimed to identify multimorbidity patterns, along with their associations with mortality, within a representative sample of the Chilean population. 3,701 participants aged ≥18 from the Chilean National Health Survey 2009-2010 were included in this prospective study. Multimorbidity patterns were identified from 16 chronic conditions and then classified using latent class analyses. All-cause mortality data were extracted from the Chilean Civil Registry. The association of classes with all-cause mortality was carried out using Cox proportional regression models, adjusting by sociodemographic and lifestyle variables. Three classes were identified: a) Class 1, the healthiest (72.1%); b) Class 2, the depression/cardiovascular disease/cancer class (17.5%); and c) Class 3, hypertension/chronic kidney disease class (10.4%). Classes 2 and 3 showed higher mortality risk than the healthiest class. After adjusting, Class 2 showed 45% higher mortality risk, and Class 3 98% higher mortality risk, compared with the healthiest class. Hypertension appeared to be a critical underlying factor of all-cause morbidity. Particular combinations of chronic diseases have a higher excess risk of mortality than others.
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Affiliation(s)
- Gabriela Nazar
- Departmento de Psicología, Universidad de Concepción, Concepción, Chile
| | - Felipe Díaz-Toro
- Facultad de Enfermería, Universidad Andres Bello, Santiago, Chile
| | - Yeny Concha-Cisternas
- Escuela de Kinesiología, Facultad de Salud, Universidad Santo Tomás, Santiago, Chile
- Pedagogía en Educación Física, Facultad de Educación, Universidad Autónoma de Chile, Providencia, Chile
| | - Ana María Leiva-Ordoñez
- Instituto Anatomía, Histología y Patología, Facultad de Medicina, Universidad Austral de Chile, Valdivia, Chile
| | - Claudia Troncoso-Pantoja
- Centro de Investigación en Educación y Desarrollo (CIEDE-UCSC), Departamento de Salud Pública, Facultad de Medicina, Universidad Católica de la Santísima Concepción, Concepción, Chile
| | - Carlos Celis-Morales
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom
- Human Performance Laboratory, Education, Physical Activity and Health Research Unit, Universidad Católica del Maule, Talca, Chile
| | - Fanny Petermann-Rocha
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom
- Centro de Investigación Biomédica, Facultad de Medicina, Universidad Diego Portales, Santiago, Chile
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Foster HM, Polz P, Gill JM, Celis-Morales C, Mair FS, O'Donnell CA. The influence of socioeconomic status on the association between unhealthy lifestyle factors and adverse health outcomes: a systematic review. Wellcome Open Res 2023; 8:55. [PMID: 38533439 PMCID: PMC10964004 DOI: 10.12688/wellcomeopenres.18708.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/04/2023] [Indexed: 03/28/2024] Open
Abstract
Background Combinations of lifestyle factors (LFs) and socioeconomic status (SES) are independently associated with cardiovascular disease (CVD), cancer, and mortality. Less advantaged SES groups may be disproportionately vulnerable to unhealthy LFs but interactions between LFs and SES remain poorly understood. This review aimed to synthesise the available evidence for whether and how SES modifies associations between combinations of LFs and adverse health outcomes. Methods Systematic review of studies that examine associations between combinations of >3 LFs (eg.smoking/physical activity/diet) and health outcomes and report data on SES (eg.income/education/poverty-index) influences on associations. Databases (PubMed/EMBASE/CINAHL), references, forward citations, and grey-literature were searched from inception to December 2021. Eligibility criteria were analyses of prospective adult cohorts that examined all-cause mortality or CVD/cancer mortality/incidence. Results Six studies (n=42,467-399,537; 46.5-56.8 years old; 54.6-59.3% women) of five cohorts were included. All examined all-cause mortality; three assessed CVD/cancer outcomes. Four studies observed multiplicative interactions between LFs and SES, but in opposing directions. Two studies tested for additive interactions; interactions were observed in one cohort (UK Biobank) and not in another (National Health and Nutrition Examination Survey (NHANES)). All-cause mortality HRs (95% confidence intervals) for unhealthy LFs (versus healthy LFs) from the most advantaged SES groups ranged from 0.68 (0.32-1.45) to 4.17 (2.27-7.69). Equivalent estimates from the least advantaged ranged from 1.30 (1.13-1.50) to 4.00 (2.22-7.14). In 19 analyses (including sensitivity analyses) of joint associations between LFs, SES, and all-cause mortality, highest all-cause mortality was observed in the unhealthiest LF-least advantaged suggesting an additive effect. Conclusions Limited and heterogenous literature suggests that the influence of SES on associations between combinations of unhealthy LFs and adverse health could be additive but remains unclear. Additional prospective analyses would help clarify whether SES modifies associations between combinations of unhealthy LFs and health outcomes. Registration Protocol is registered with PROSPERO (CRD42020172588;25 June 2020).
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Affiliation(s)
- Hamish M.E. Foster
- General Practice and Primary Care, School of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, Scotland, G12 9LX, UK
| | - Peter Polz
- General Practice and Primary Care, School of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, Scotland, G12 9LX, UK
| | - Jason M.R. Gill
- School of Cardiovascular and Metabolic Health, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, Scoland, G12 8TA, UK
| | - Carlos Celis-Morales
- School of Cardiovascular and Metabolic Health, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, Scoland, G12 8TA, UK
| | - Frances S. Mair
- General Practice and Primary Care, School of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, Scotland, G12 9LX, UK
| | - Catherine A. O'Donnell
- General Practice and Primary Care, School of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, Scotland, G12 9LX, UK
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11
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Nazar G, Díaz-Toro F, Petermann-Rocha F, Lanuza F, Troncoso C, Leiva-Ordóñez AM, Concha-Cisternas Y, Celis-Morales C. Multimorbidity and 11-year mortality in adults: a prospective analysis using the Chilean National Health Survey. Health Promot Int 2023; 38:daad176. [PMID: 38128083 DOI: 10.1093/heapro/daad176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Abstract
Research on morbidity and mortality often emphasizes individual diseases over the cumulative effects of multimorbidity, especially in low- and middle-income countries. This study aimed to analyze the association between multimorbidity and all-cause mortality in a representative sample of the Chilean population. This longitudinal study used data from 3701 subjects aged ≥15 years who participated in the Chilean National Health Survey conducted between 2009 and 2010. We included 16 self-reported highly prevalent morbidities. All-cause mortality data from an 11-year follow-up were collected from the Chilean Civil Registry. The Cox proportional hazard model, adjusted for confounders, determined the association between multimorbidity categories and all-cause mortality. Of the total sample, 24.3% reported no morbidity, while 50.4% two or more. After adjustment, participants with four or more morbidities had a 1.66 times higher mortality risk [95% confidence interval (CI): 1.03-2.67] than those without morbidities. The mortality risk increased by 10% for each additional morbidity [HR: 1.09 (CI: 1.04-1.16)]. Multimorbidity was common in the Chilean population and increased the mortality risk, which greatly challenges the health system to provide an integral and coordinated approach to healthcare.
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Affiliation(s)
- Gabriela Nazar
- Departamento de Psicología, Universidad de Concepción, Concepción, 834-0518, Chile
| | - Felipe Díaz-Toro
- Facultad de Enfermería, Universidad Andres Bello, Santiago, 8370134, Chile
| | - Fanny Petermann-Rocha
- Facultad de Medicina, Centro de Investigación Biomédica, Universidad Diego Portales, Santiago, 8370134, Chile
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, G12 8TA, United Kingdom
| | - Fabián Lanuza
- Departamento de Procesos Diagnósticos y Evaluación, Facultad de Ciencias de la Salud, Universidad Católica de Temuco, 4813302, Chile
| | - Claudia Troncoso
- Facultad de Medicina. Departamento de Salud Pública, Centro de Investigación en Educación y Desarrollo (CIEDE-UCSC), Universidad Católica de la Santísima Concepción, Concepción, 4090541, Chile
| | - Ana María Leiva-Ordóñez
- Facultad de Medicina, Instituto de Anatomía, Histología y Patología, Universidad Austral de Chile, Valdivia, 4811230, Chile
| | - Yeny Concha-Cisternas
- Facultad de Salud, Escuela de Kinesiología, Universidad Santo Tomás, Talca, 3465548, Chile
- Facultad de Educación, Pedagogía en Educación Física, Universidad Autónoma de Chile, Talca, Chile
| | - Carlos Celis-Morales
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, G12 8TA, United Kingdom
- Human Performance Laboratory, Education, Physical Activity and Health Research Unit, Universidad Católica del Maule, Talca, 34809112, Chile
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12
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Malcomson FC, Parra-Soto S, Ho FK, Lu L, Celis-Morales C, Sharp L, Mathers JC. Adherence to the 2018 World Cancer Research Fund (WCRF)/American Institute for Cancer Research (AICR) Cancer Prevention Recommendations and risk of 14 lifestyle-related cancers in the UK Biobank prospective cohort study. BMC Med 2023; 21:407. [PMID: 38012714 PMCID: PMC10683228 DOI: 10.1186/s12916-023-03107-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 10/05/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND The World Cancer Research Fund (WCRF)/American Institute for Cancer Research (AICR) Cancer Prevention Recommendations are lifestyle-based recommendations which aim to reduce cancer risk. This study investigated associations between adherence, assessed using a standardised scoring system, and the risk of all cancers combined and of 14 cancers for which there is strong evidence for links with aspects of lifestyle in the UK. METHODS We used data from 94,778 participants (53% female, mean age 56 years) from the UK Biobank. Total adherence scores (range 0-7 points) were derived from dietary, physical activity, and anthropometric data. Associations between total score and cancer risk (all cancers combined; and prostate, breast, colorectal, lung, uterine, liver, pancreatic, stomach, oesophageal, head and neck, ovarian, kidney, bladder, and gallbladder cancer) were investigated using Cox proportional hazard models, adjusting for age, sex, deprivation index, ethnicity, and smoking status. RESULTS Mean total score was 3.8 (SD 1.0) points. During a median follow-up of 8 years, 7296 individuals developed cancer. Total score was inversely associated with risk of all cancers combined (HR: 0.93; 95%CI: 0.90-0.95 per 1-point increment), as well as breast (HR: 0.90; 95%CI: 0.86-0.95), colorectal (HR: 0.90; 95%CI: 0.84-0.97), kidney (HR: 0.82; 95%CI: 0.72-0.94), oesophageal (HR: 0.84; 95%CI: 0.71-0.98), ovarian (HR: 0.76; 95%CI: 0.65-0.90), liver (HR: 0.78; 95%CI: 0.63-0.97), and gallbladder (HR: 0.70; 95%CI: 0.53-0.93) cancers. CONCLUSIONS Greater adherence to lifestyle-based recommendations was associated with reduced risk of all cancers combined and of breast, colorectal, kidney, oesophageal, ovarian, liver, and gallbladder cancers. Our findings support compliance with the Cancer Prevention Recommendations for cancer prevention in the UK.
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Affiliation(s)
- Fiona C Malcomson
- Human Nutrition & Exercise Research Centre, Centre for Healthier Lives, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
- Centre for Cancer, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - Solange Parra-Soto
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
- School of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
- Department of Nutrition and Public Health, Universidad del Bío-Bío, Chillan, Chile
| | - Frederick K Ho
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Liya Lu
- Centre for Cancer, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - Carlos Celis-Morales
- School of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
- Human Performance Lab, Education, Physical Activity and Health Research Unit, University Católica del Maule, Talca, Chile
| | - Linda Sharp
- Centre for Cancer, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - John C Mathers
- Human Nutrition & Exercise Research Centre, Centre for Healthier Lives, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK.
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13
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Fadnes LT, Celis-Morales C, Økland JM, Parra-Soto S, Livingstone KM, Ho FK, Pell JP, Balakrishna R, Javadi Arjmand E, Johansson KA, Haaland ØA, Mathers JC. Life expectancy can increase by up to 10 years following sustained shifts towards healthier diets in the United Kingdom. Nat Food 2023; 4:961-965. [PMID: 37985698 PMCID: PMC10661734 DOI: 10.1038/s43016-023-00868-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 09/29/2023] [Indexed: 11/22/2023]
Abstract
Adherence to healthy dietary patterns can prevent the development of non-communicable diseases and affect life expectancy. Here, using a prospective population-based cohort data from the UK Biobank, we show that sustained dietary change from unhealthy dietary patterns to the Eatwell Guide dietary recommendations is associated with 8.9 and 8.6 years gain in life expectancy for 40-year-old males and females, respectively. In the same population, sustained dietary change from unhealthy to longevity-associated dietary patterns is associated with 10.8 and 10.4 years gain in life expectancy in males and females, respectively. The largest gains are obtained from consuming more whole grains, nuts and fruits and less sugar-sweetened beverages and processed meats. Understanding the contribution of sustained dietary changes to life expectancy can provide guidance for the development of health policies.
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Affiliation(s)
- Lars T Fadnes
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
- Bergen Addiction Research, Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway.
| | - Carlos Celis-Morales
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
- Education, Physical Activity and Health Research Unit, University Católica del Maule, Talca, Chile
| | - Jan-Magnus Økland
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Bergen Centre for Ethics and Priority Setting, University of Bergen, Bergen, Norway
| | - Solange Parra-Soto
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
- Department of Nutrition and Public Health, Universidad del Bío-Bío, Chillán, Chile
| | - Katherine M Livingstone
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Frederick K Ho
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Jill P Pell
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Rajiv Balakrishna
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Elaheh Javadi Arjmand
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Bergen Addiction Research, Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway
| | - Kjell Arne Johansson
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Bergen Addiction Research, Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway
- Bergen Centre for Ethics and Priority Setting, University of Bergen, Bergen, Norway
| | - Øystein A Haaland
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Bergen Centre for Ethics and Priority Setting, University of Bergen, Bergen, Norway
| | - John C Mathers
- Human Nutrition and Exercise Research Centre, Centre for Healthier Lives, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
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14
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Petermann-Rocha F, Deo S, Lyall D, Orkaby AR, Quinn TJ, Sattar N, Celis-Morales C, Pell JP, Ho FK. Association Between the AHA Life's Essential 8 Score and Incident All-Cause Dementia: A Prospective Cohort Study from UK Biobank. Curr Probl Cardiol 2023; 48:101934. [PMID: 37422047 DOI: 10.1016/j.cpcardiol.2023.101934] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 07/04/2023] [Indexed: 07/10/2023]
Abstract
This study aimed to investigate the association between the Life's Essential 8 (LE8) score and incident all-cause dementia (including Alzheimer's disease [AD] and vascular dementia) in UK Biobank. A total of 259,718 participants were included in this prospective study. Smoking, non-HDL cholesterol, blood pressure, body mass index, HbA1c, physical activity, diet, and sleep were used to create the Life's Essential 8 (LE8) score. Associations between the score (both continuous and as quartiles) and outcomes were investigated using adjusted Cox proportional hazard models. The potential impact fractions of 2 scenarios and the rate advancement periods were also calculated. Over a median follow-up of 10.6 years, 4958 participants were diagnosed with any dementia. Higher LE8 scores were associated with lower risk of all-cause and vascular dementia in an exponential decay pattern. Compared with individuals in the healthiest quartile, those in the least healthy quartile had a higher risk of all-cause dementia (HR: 1.50 [95% CI: 1.37-1.65] and vascular dementia (HR: 1.86 [1.44-2.42]). A targeted intervention that increased the score by 10-points among individuals in the lowest quartile could have prevented 6.8% of all-cause dementia cases. Individuals in the least healthy LE8 quartile might develop all-cause dementia 2.45 years earlier than their counterparts. In conclusion, individuals with higher LE8 scores had lower risk of all-cause and vascular dementia. Because of nonlinear associations, interventions targeted at the least healthy individuals might produce greater population-level benefits.
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Affiliation(s)
- Fanny Petermann-Rocha
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom; Centro de Investigación Biomédica, Facultad de Medicina, Universidad Diego Portales, Santiago, Chile
| | - Salil Deo
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom; Division of Cardiothoracic Surgery Surgical Services, Louis Stokes Cleveland VA Medical Center, Cleveland, OH; Case School of Medicine, Case Western Reserve University, Cleveland, OH
| | - Donald Lyall
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Ariela R Orkaby
- New England Geriatric Research, Education, and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA; Division of Aging, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Terence J Quinn
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom
| | - Naveed Sattar
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom
| | - Carlos Celis-Morales
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom; Human Performance Laboratory, Education, Physical Activity and Health Research Unit, Universidad Católica del Maule, Talca, Chile
| | - Jill P Pell
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Frederick K Ho
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom.
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15
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Malcomson FC, Wiggins C, Parra-Soto S, Ho FK, Celis-Morales C, Sharp L, Mathers JC. Adherence to the 2018 World Cancer Research Fund/American Institute for Cancer Research Cancer Prevention Recommendations and cancer risk: A systematic review and meta-analysis. Cancer 2023; 129:2655-2670. [PMID: 37309215 DOI: 10.1002/cncr.34842] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 03/28/2023] [Accepted: 04/06/2023] [Indexed: 06/14/2023]
Abstract
BACKGROUND The World Cancer Research Fund/American Institute for Cancer Research Cancer Prevention Recommendations are lifestyle-based guidelines that aim to reduce cancer risk. A systematic review and meta-analysis of studies investigating associations between a score for adherence to the 2018 Cancer Prevention Recommendations and cancer risk was conducted. METHODS MEDLINE, Embase, Web of Science, and Scopus were searched for studies published to November 28, 2022. In meta-analysis, the estimated risk ratios and 95% CIs for adherence score as a continuous (per 1-point increment) and categorical (highest vs. lowest score category) variable using random-effects models were estimated. RESULTS Eighteen studies (11 cohort; seven case-control) were included investigating incidence of breast (n = 7), colorectal (n = 5), prostate (n = 2), lung (n = 2), pancreatic (n = 1), endometrial (n = 1), unknown primary cancer (n = 1), chronic lymphocytic leukemia (n = 1), and overall (any) cancer (n = 1). The summary risk ratio per 1-point increment in adherence score was 0.89 (95% CI, 0.85-0.93; I2 = 76.5%; n = 7) for breast cancer, 0.88 (95% CI, 0.84-0.91; I2 = 26.2%; n = 4) for colorectal cancer, and 0.92 (95% CI, 0.86-0.98, I2 = 66.0%; n = 2) for lung cancer. There were no significant associations with prostate or other cancers. Meta-analysis results using categorical adherence score variables were consistent with these findings. CONCLUSIONS Greater adherence to the 2018 World Cancer Research Fund/American Institute for Cancer Research Cancer Prevention Recommendations was associated with lower risk of breast, colorectal, and lung cancers. Future studies investigating associations with risk of other forms of cancer are warranted. PROSPERO REGISTRATION NUMBER CRD42022313327.
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Affiliation(s)
- Fiona C Malcomson
- Human Nutrition & Exercise Research Centre, Centre for Healthier Lives, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Christopher Wiggins
- Human Nutrition & Exercise Research Centre, Centre for Healthier Lives, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Solange Parra-Soto
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
- Department of Nutrition and Public Health, Universidad del Bío-Bío, Chillan, Chile
| | - Frederick K Ho
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Carlos Celis-Morales
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
- Human Performance Lab, Education, Physical Activity and Health Research Unit, University Católica del Maule, Talca, Chile
| | - Linda Sharp
- Centre for Cancer, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - John C Mathers
- Human Nutrition & Exercise Research Centre, Centre for Healthier Lives, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
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16
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Ho FK, Wirth MD, Parra-Soto S, Boonpor J, Zhou Z, Petermann-Rocha F, Nakada S, Livingstone KM, Mathers JC, Pell JP, Hébert JR, Celis-Morales C. Dose-Response Associations of Dietary Inflammatory Potential With Health Outcomes: A Prospective Cohort Study of 198,265 UK Biobank Participants. Curr Probl Cardiol 2023; 48:101774. [PMID: 37121456 DOI: 10.1016/j.cpcardiol.2023.101774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 04/26/2023] [Indexed: 05/02/2023]
Abstract
To investigate the dose-response associations of dietary inflammatory potential with all-cause mortality and incident cardiovascular disease (CVD) and cancer. METHODS This was a prospective cohort study of 198,265 UK Biobank participants who completed at least 1 dietary assessment. A web based 24 hours recall questionnaire was used to derive the energy-adjusted dietary inflammatory index (E-DII). All-cause mortality and incident CVD and cancer ascertained from linked records. RESULTS After adjusting for socio-demographic and lifestyle factors, there were J-shaped associations of E-DII with all-cause mortality and CVD, and a relatively linear association with cancer. When E-DII was <0, E-DII was not associated with any of the outcomes. When E-DII was ≥0, the linear associations were strongest in all-cause mortality (HR 1.09, 95% CI, 1.05-1.13), followed by CVD (HR 1.06, 95% CI, 1.03-1.09), and cancer (HR 1.03, 95%,CI, 1.01-1.05). CONCLUSION Dietary inflammatory potential was associated with mortality and CVD primarily when the diet is proinflammatory.
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Affiliation(s)
- Frederick K Ho
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Michael D Wirth
- College of Nursing, University of South Carolina, Columbia, SC; Department of Epidemiology and Biostatistics, Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | - Solange Parra-Soto
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK; BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular Medical Sciences, University of Glasgow, Glasgow, UK
| | - Jirapitcha Boonpor
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK; BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular Medical Sciences, University of Glasgow, Glasgow, UK; Faculty of Public Health, Chalermphrakiat Sakon Nakhon Province Campus, Kasetsart University, Sakon Nakhon, Thailand
| | - Ziyi Zhou
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Fanny Petermann-Rocha
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK; Facultad de Medicina, Universidad Diego Portales, Santiago, Chile
| | - Shinya Nakada
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Katherine M Livingstone
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - John C Mathers
- Human Nutrition Research Centre, Centre for Healthier Lives, Population Health Sciences Institute, Newcastle University, Newcastle, UK
| | - Jill P Pell
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - James R Hébert
- Department of Epidemiology and Biostatistics, Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | - Carlos Celis-Morales
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK; Human Performance Laboratory, Education, Physical Activity and Health Research Unit, Universidad Católica del Maule, Talca, Chile.
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17
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Nakada S, Ho FK, Celis-Morales C, Pell JP. Association between being breastfed and cardiovascular disease: a population cohort study of 320 249 participants. J Public Health (Oxf) 2023; 45:569-576. [PMID: 36879421 PMCID: PMC10470327 DOI: 10.1093/pubmed/fdad016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
Abstract
BACKGROUND Being breastfed is associated with lower cardiovascular risk factors but, to date, no studies have demonstrated a protective effect on cardiovascular disease (CVD). This study aims to address the limitations of previous studies, specifically insufficient statistical power and residual confounding, to determine if such association exists. METHODS This is a population-based retrospective cohort study of 320 249 men and women aged 40-69 years. Breastfeeding status was self-reported. CVD and myocardial infarction (MI) events and deaths based via linkage to hospitalization and death records. RESULTS Overall, 28 469 (8.4%) participants experienced a CVD event and 5174 (1.6%) experienced an MI. Following adjustment for sociodemographic, lifestyle and early life confounders, breastfeeding was associated with a reduced risk of CVD events (HR 0.97, 95% CI 0.94-1.00, P = 0.041), CVD deaths (HR 0.91, 95% CI 0.84-0.98, P = 0.017), MI events (HR 0.93, 95% CI 0.87-0.99, P = 0.033) and MI deaths (HR 0.81, 95% CI 0.67-0.98, P = 0.026). CONCLUSIONS Child health benefits of breastfeeding are well established. However, the benefits of breastfeeding may extend into later life reinforcing the need to encourage and support breastfeeding.
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Affiliation(s)
- Shinya Nakada
- School of Health and Wellbeing, University of Glasgow, Glasgow G12 8RZ, UK
| | - Frederick K Ho
- School of Health and Wellbeing, University of Glasgow, Glasgow G12 8RZ, UK
| | - Carlos Celis-Morales
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow G12 8TA, UK
- Human Performance Lab, Education, Physical Activity and Health Research Unit, University Católica del Maule, Talca 3466706, Chile
| | - Jill P Pell
- School of Health and Wellbeing, University of Glasgow, Glasgow G12 8RZ, UK
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Nakada S, Ho FK, Celis-Morales C, Jackson CA, Pell JP. Individual and joint associations of anxiety disorder and depression with cardiovascular disease: A UK Biobank prospective cohort study. Eur Psychiatry 2023:1-17. [PMID: 37403371 PMCID: PMC10377450 DOI: 10.1192/j.eurpsy.2023.2425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/06/2023] Open
Abstract
BACKGROUND Growing evidence suggests that individuals with anxiety disorder have an elevated risk of cardiovascular disease (CVD) but few studies have assessed this association independently of or jointly with depression. METHODS We conducted a prospective cohort study using UK Biobank. Diagnoses of anxiety disorder, depression, and CVDs were ascertained through linked hospital admission and mortality data. Individual and joint associations between anxiety disorder and depression and CVD overall, as well as each of myocardial infarction, stroke/transient ischemic attack, and heart failure, were analyzed using Cox proportional hazard models and interaction tests. RESULTS Among the 431,973 participants, the risk of CVD was higher among those who had been diagnosed with anxiety disorder only (hazard ratio [HR] 1.72; 95% confidence interval [CI] 1.32-2.24), depression only (HR 2.07; 95% CI 1.79-2.40), and both conditions (HR 2.89; 95% CI 2.03-4.11) compared to those without these conditions, respectively. There was very little evidence of multiplicative or additive interaction. Results were similar for myocardial infarction, stroke/transient ischemic attack, and heart failure. CONCLUSIONS Having anxiety is associated with the same magnitude of increased risk of CVD among people who do not have depression and those who do. Anxiety disorder should be considered for inclusion in CVD risk prediction and stratification, in addition to depression.
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Affiliation(s)
- Shinya Nakada
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Frederick K Ho
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Carlos Celis-Morales
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow G12 8TA
- Human Performance Laboratory, Education, Physical Activity and Health Research Unit, Universidad Católica del Maule, Talca, Chile
| | | | - Jill P Pell
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
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Soltanisarvestani M, Lynskey N, Gray S, Gill JMR, Pell JP, Sattar N, Welsh P, Ho FK, Celis-Morales C, Peterman-Rocha F. Associations of grip strength and walking pace with mortality in stroke survivors: A prospective study from UK Biobank. Scand J Med Sci Sports 2023; 33:1190-1200. [PMID: 36932055 DOI: 10.1111/sms.14352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 03/09/2023] [Accepted: 03/10/2023] [Indexed: 03/19/2023]
Abstract
INTRODUCTION Although stroke is an emerging cause of disability and mortality globally, associations between physical capability markers and mortality in stroke survivors are elusive. This study investigated the individual and combined associations of walking pace and grip strength with all-cause and stroke mortality in stroke survivors. METHODS Individual and combined associations of walking pace and grip strength with stroke deaths and all-cause mortality were investigated using Cox proportional-hazard models adjusted for sociodemographic, lifestyle, and health-related variables. RESULTS Seven thousand four hundred eighty-six stroke survivors from the UK Biobank study (aged 40-70 years; 42.4% women) were included in this prospective study. Over a median follow-up of 12.6 (IQR: 11.9-13.3) years, 1490 (19.9%) participants died, of whom 222 (3.0%) died from stroke. After adjusting for confounding factors, and compared to individuals in the average/brisk walking pace category, those who reported a slow walking pace had 2.00 (95% CI: 1.50-2.68) and 1.99 (95% CI: 1.78-2.23) times higher risk of stroke mortality and all-cause mortality, respectively. Similar associations were identified for participants with low grip strength compared with those with normal levels. For combined associations, those with both slow walking pace and low grip strength showed the highest risk of stroke mortality (hazard ratio: 2.86 [95% CI: 1.93-4.22]). Similar results were found for all-cause mortality. CONCLUSIONS Low grip strength and slow walking pace were associated with a higher risk of stroke and all-cause mortality in stroke survivors. If these associations are causal, improving physical capability among stroke survivors might potentially prolong survival.
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Affiliation(s)
- Maryam Soltanisarvestani
- British Heart Foundation Glasgow Cardiovascular Research Centre, School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
| | - Nathan Lynskey
- British Heart Foundation Glasgow Cardiovascular Research Centre, School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
| | - Stuart Gray
- British Heart Foundation Glasgow Cardiovascular Research Centre, School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
| | - Jason M R Gill
- British Heart Foundation Glasgow Cardiovascular Research Centre, School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
| | - Jill P Pell
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Naveed Sattar
- British Heart Foundation Glasgow Cardiovascular Research Centre, School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
| | - Paul Welsh
- British Heart Foundation Glasgow Cardiovascular Research Centre, School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
| | - Frederick K Ho
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Carlos Celis-Morales
- British Heart Foundation Glasgow Cardiovascular Research Centre, School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
- Laboratorio de Rendimiento Humano, Grupo de Estudio en Educación, Actividad Física y Salud (GEEAFyS), Universidad Católica del Maule, Talca, Chile
| | - Fanny Peterman-Rocha
- British Heart Foundation Glasgow Cardiovascular Research Centre, School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
- Centro de Investigación Biomédica, Facultad de Medicina, Universidad Diego Portales, Santiago, Chile
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Boonpor J, Parra-Soto S, Petermann-Rocha F, Lynskey N, Cabanas-Sánchez V, Sattar N, Gill JMR, Welsh P, Pell JP, Gray SR, Ho FK, Celis-Morales C. Dose-response relationship between device-measured physical activity and incident type 2 diabetes: findings from the UK Biobank prospective cohort study. BMC Med 2023; 21:191. [PMID: 37226202 DOI: 10.1186/s12916-023-02851-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 03/27/2023] [Indexed: 05/26/2023] Open
Abstract
BACKGROUND Most studies investigating the association between physical activity (PA) and the risk of type 2 diabetes are derived from self-reported questionnaires, with limited evidence using device-based measurements. Therefore, this study aimed to investigate the dose-response relationship between device-measured PA and incident type 2 diabetes. METHODS This prospective cohort study included 40,431 participants of the UK Biobank. Wrist-worn accelerometers were used to estimate total, light, moderate, vigorous and moderate-to-vigorous PA. The associations between PA and incident type 2 diabetes were analysed using Cox-proportional hazard models. The mediating role of body mass index (BMI) was tested under a causal counterfactual framework. RESULTS The median follow-up period was 6.3 years (IQR: 5.7-6.8), with 591 participants developing type 2 diabetes. Compared to those achieving < 150 min/week of moderate PA, people achieving 150-300, 300-600 and > 600 min/week were at 49% (95% CI 62-32%), 62% (95% CI 71-50%) and 71% (95% CI 80-59%) lower risk of type 2 diabetes, respectively. For vigorous PA, compared to those achieving < 25 min/week, individuals achieving 25-50, 50-75 and > 75 min/week were at 38% (95% CI 48-33%), 48% (95% CI 64-23%) and 64% (95% CI 78-42%) lower type 2 diabetes risk, respectively. Twelve per cent and 20% of the associations between vigorous and moderate PA and type 2 diabetes were mediated by lower BMI, respectively. CONCLUSIONS PA has clear dose-response relationship with a lower risk of type 2 diabetes. Our findings support the current aerobic PA recommendations but suggest that additional PA beyond the recommendations is associated with even greater risk reduction. TRIAL REGISTRATION The UK Biobank study was approved by the North West Multi-Centre Research Ethics Committee (Ref 11/NW/0382 on June 17, 2011).
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Affiliation(s)
- Jirapitcha Boonpor
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
- Faculty of Public Health, Kasetsart University, Chalermphrakiat Sakon Nakhon Province Campus, Sakon Nakhon, Thailand
| | - Solange Parra-Soto
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
- Department of Nutrition and Public Health, Universidad del Bío-Bío, Chillan, Chile
| | - Fanny Petermann-Rocha
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
- Facultad de Medicina, Universidad Diego Portales, Santiago, Chile
| | - Nathan Lynskey
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
| | - Verónica Cabanas-Sánchez
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
- IMDEA Food Institute, CEI UAM+CSIC, Madrid, Spain
| | - Naveed Sattar
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
| | - Jason M R Gill
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
| | - Paul Welsh
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
| | - Jill P Pell
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Stuart R Gray
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
| | - Frederick K Ho
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Carlos Celis-Morales
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK.
- Human Performance Lab, Education, Physical Activity and Health Research Unit, Universidad Católica del Maule, Talca, Chile.
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Nazar G, Díaz-Toro F, Roa P, Petermann-Rocha F, Troncoso-Pantoja C, Leiva-Ordóñez AM, Cigarroa I, Celis-Morales C. [Association between oral health and cognitive decline in older Chileans]. Gac Sanit 2023; 37:102303. [PMID: 37156068 DOI: 10.1016/j.gaceta.2023.102303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 12/29/2022] [Accepted: 02/20/2023] [Indexed: 05/10/2023]
Abstract
OBJECTIVE To identify the association between oral health and suspected cognitive impairment in older adults in Chile. METHOD Cross-sectional study including 1826 people ≥60 years who participated in the National Health Survey of Chile, 2016-2017. Oral health was evaluated by the number of teeth, presence of caries, use of dental prostheses, self-reported oral health, and pain and/or discomfort in the oral cavity. Cognitive impairment was assessed using the Mini-Mental State Examination (MMSE). The association was evaluated by logistic and linear regression, adjusted for sociodemographic and lifestyle variables. RESULTS Compared with people without suspicion of cognitive impairment, people with suspected impairment had five fewer teeth (13.4 vs. 8.5 teeth), a much higher difference in women than in men, and a higher frequency of oral pain. Edentulism and fewer teeth were associated with a higher likelihood of suspected cognitive impairment, associations that were not maintained in adjusted models. Oral pain was associated with a higher likelihood of suspected impairment even in the most adjusted model (odds ratio: 1.99; 95% confidence interval [95%CI]: 1.09-3.63). In linear models, an increase of 2% (95%CI: 0.01-0.05) in the MMSE score was observed for each additional tooth. CONCLUSIONS Poor oral health, particularly tooth loss and the presence of pain, was associated with cognitive impairment in older adults in Chile.
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Affiliation(s)
- Gabriela Nazar
- Departamento de Psicología, Facultad de Ciencias Sociales y Centro de Vida Saludable, Universidad de Concepción, Concepción, Chile
| | - Felipe Díaz-Toro
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA; Facultad de Enfermería, Escuela de Enfermería, Universidad Andrés Bello, Santiago, Chile.
| | - Pablo Roa
- Departamento de Fonoaudiología, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile; Doctorado Salud Mental, Departamento de Psiquiatría, Universidad de Concepción, Concepción, Chile
| | - Fanny Petermann-Rocha
- Centro de Investigación Biomédica, Facultad de Medicina, Universidad Diego Portales, Santiago, Chile
| | - Claudia Troncoso-Pantoja
- Centro de Investigación en Educación y Desarrollo (CIEDE-UCSC), Departamento de Salud Pública, Facultad de Medicina, Universidad Católica de la Santísima Concepción, Concepción, Chile
| | - Ana María Leiva-Ordóñez
- Instituto de Anatomía, Histología y Patología, Facultad de Medicina, Universidad Austral de Chile, Valdivia, Chile
| | - Igor Cigarroa
- Escuela de Kinesiología, Facultad de Salud, Universidad Santo Tomás, Los Ángeles, Chile
| | - Carlos Celis-Morales
- BHF Glasgow Cardiovascular Research Centre, School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom; Laboratorio de Rendimiento Humano, Grupo de Estudio en Educación, Actividad Física y Salud (GEEAFyS), Universidad Católica del Maule, Talca, Chile
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Cigarroa I, Bravo-Leal M, Petermann-Rocha F, Parra-Soto S, Concha-Cisternas Y, Matus-Castillo C, Vásquez-Gómez J, Zapata-Lamana R, Parra-Rizo MA, Álvarez C, Celis-Morales C. Brisk Walking Pace Is Associated with Better Cardiometabolic Health in Adults: Findings from the Chilean National Health Survey 2016-2017. Int J Environ Res Public Health 2023; 20:ijerph20085490. [PMID: 37107772 PMCID: PMC10139031 DOI: 10.3390/ijerph20085490] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 02/15/2023] [Accepted: 03/15/2023] [Indexed: 05/11/2023]
Abstract
BACKGROUND Although the importance of walking for promoting a better cardiometabolic health is widely known (this includes both cardiovascular and metabolic/endocrine systems), there is little knowledge regarding its appropriate pace to provide adults with more cardiometabolic benefits. AIM To analyze the associations between different walking pace categories and cardiometabolic health markers in the adult Chilean population. METHODS Cross-sectional study. A total of 5520 participants aged 15 to 90 years old from the Chilean National Health Survey (CNHS) 2016-2017 were included. Walking pace categories (slow, average, and brisk) were collected through self-reported methods. Glycaemia, glycosylated hemoglobin (HbA1c), gamma glutamyl transferase (GGT), vitamin D2, vitamin D3, systolic and diastolic blood pressure, and lipid profile (Total, HDL, LDL, VLDL, No HDL cholesterol and triglycerides) were determined using blood sample tests and measured with the standardized methods described in the CNHS 2016-2017. RESULTS People who had a brisk walking pace were associated with lower levels of glycaemia, HbA1c, GGT, systolic and diastolic blood pressure, and higher vitamin D3 levels compared with those with a slow walking pace. Moreover, people with a brisk walking pace had lower levels of VLDL cholesterol compared with those with a slow walking pace. However, after adjusting the model to include sociodemographic background, nutritional status, and lifestyle variables, the differences remained only for glycaemia, HbA1c and systolic blood pressure levels. CONCLUSIONS A brisk walking pace was associated with better cardiometabolic health markers and lipid profile compared with a slow walking pace.
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Affiliation(s)
- Igor Cigarroa
- Escuela de Kinesiología, Facultad de Salud, Universidad Santo Tomás, Los Ángeles 4440000, Chile
- Correspondence:
| | - Michelle Bravo-Leal
- Escuela de Kinesiología, Facultad de Salud, Universidad Santo Tomás, Los Ángeles 4440000, Chile
| | - Fanny Petermann-Rocha
- Centro de Investigación Biomédica, Facultad de Medicina, Universidad Diego Portales, Santiago 8370068, Chile
| | - Solange Parra-Soto
- Department of Nutrition and Public Health, Universidad del Bío-Bío, Chillan 3780000, Chile
- School Cardiovascular and Metabolic Health, University of Glasgow, Glasgow G12 8TA, UK
| | - Yeny Concha-Cisternas
- Pedagogía en Educación Física, Facultad de Educación, Universidad Autónoma de Chile, Talca 3460000, Chile
| | - Carlos Matus-Castillo
- Departamento de Ciencias del Deporte y Acondicionamiento Físico, Universidad Católica de la Santísima Concepción, Concepción 4030000, Chile
| | - Jaime Vásquez-Gómez
- Centro de Investigación de Estudios Avanzados del Maule (CIEAM), Universidad Católica del Maule, Talca 3460000, Chile
- Laboratorio de Rendimiento Humano, Grupo de Estudios en Educación, Actividad Física y Salud (GEEAFyS), Universidad Católica del Maule, Talca 3460000, Chile
| | | | - María Antonia Parra-Rizo
- Faculty of Health Sciences, Valencian International University—VIU, 46002 Valencia, Spain
- Department of Health Psychology, Faculty of Social and Health Sciences, Campus of Elche, Miguel Hernandez University (UMH), 03202 Elche, Spain
| | - Cristian Álvarez
- Exercise and Rehabilitation Sciences Institute, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago 7591538, Chile
| | - Carlos Celis-Morales
- School Cardiovascular and Metabolic Health, University of Glasgow, Glasgow G12 8TA, UK
- Laboratorio de Rendimiento Humano, Grupo de Estudios en Educación, Actividad Física y Salud (GEEAFyS), Universidad Católica del Maule, Talca 3460000, Chile
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Petermann-Rocha F, Wirth MD, Boonpor J, Parra-Soto S, Zhou Z, Mathers JC, Livingstone K, Forrest E, Pell JP, Ho FK, Hébert JR, Celis-Morales C. Associations between an inflammatory diet index and severe non-alcoholic fatty liver disease: a prospective study of 171,544 UK Biobank participants. BMC Med 2023; 21:123. [PMID: 37013578 PMCID: PMC10071692 DOI: 10.1186/s12916-023-02793-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 02/17/2023] [Indexed: 04/05/2023] Open
Abstract
BACKGROUND Although non-alcoholic fatty liver disease (NAFLD) is linked to inflammation, whether an inflammatory diet increases the risk of NAFLD is unclear. This study aimed to examine the association between the Energy-adjusted Diet Inflammatory Index (E-DII) score and severe NAFLD using UK Biobank. METHODS This prospective cohort study included 171,544 UK Biobank participants. The E-DII score was computed using 18 food parameters. Associations between the E-DII and incident severe NAFLD (defined as hospital admission or death) were first investigated by E-DII categories (very/moderately anti-inflammatory [E-DII < - 1], neutral [E-DII - 1 to 1] and very/moderately pro-inflammatory [E-DII > 1]) using Cox proportional hazard models. Nonlinear associations were investigated using penalised cubic splines fitted into the Cox proportional hazard models. Analyses were adjusted for sociodemographic, lifestyle and health-related factors. RESULTS Over a median follow-up of 10.2 years, 1489 participants developed severe NAFLD. After adjusting for confounders, individuals in the very/moderately pro-inflammatory category had a higher risk (HR: 1.19 [95% CI: 1.03 to 1.38]) of incident severe NAFLD compared with those in the very/moderately anti-inflammatory category. There was some evidence of nonlinearity between the E-DII score and severe NAFLD. CONCLUSIONS Pro-inflammatory diets were associated with a higher risk of severe NAFLD independent of confounders such as the components of the metabolic syndrome. Considering there is no recommended treatment for the disease, our findings suggest a potential means to lower the risk of NAFLD.
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Affiliation(s)
- Fanny Petermann-Rocha
- School of Cardiovascular and Medical Health, BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, G12 8TA, UK
- Centro de Investigación Biomédica, Facultad de Medicina, Universidad Diego Portales, Santiago, Chile
| | - Michael D Wirth
- College of Nursing, University of South Carolina, Columbia, USA
- Department of Epidemiology and Biostatistics and Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, USA
| | - Jirapitcha Boonpor
- School of Cardiovascular and Medical Health, BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, G12 8TA, UK
- Faculty of Public Health, Chalermphrakiat Sakon Nakhon Province Campus, Kasetsart University, Sakon Nakhon, Thailand
| | - Solange Parra-Soto
- School of Cardiovascular and Medical Health, BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, G12 8TA, UK
- Department of Nutrition and Public Health, Universidad del Bío-Bío, Chillan, Chile
| | - Ziyi Zhou
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - John C Mathers
- Human Nutrition Research Centre, Centre for Healthier Lives, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, NE2 4HH, UK
| | - Katherine Livingstone
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, 3220, Australia
| | - Ewan Forrest
- Department of Gastroenterology, Glasgow Royal Infirmary, University of Glasgow, Glasgow, UK
| | - Jill P Pell
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Frederick K Ho
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - James R Hébert
- Department of Epidemiology and Biostatistics and Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, USA
| | - Carlos Celis-Morales
- School of Cardiovascular and Medical Health, BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, G12 8TA, UK.
- Human Performance Laboratory, Education, Physical Activity and Health Research Unit, Universidad Católica del Maule, Talca, Chile.
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Petermann-Rocha F, Deo S, Celis-Morales C, Ho FK, Bahuguna P, McAllister D, Sattar N, Pell JP. An Opportunity for Prevention: Associations Between the Life's Essential 8 Score and Cardiovascular Incidence Using Prospective Data from UK Biobank. Curr Probl Cardiol 2023; 48:101540. [PMID: 36528209 DOI: 10.1016/j.cpcardiol.2022.101540] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022]
Abstract
To investigate the association between the Life's Essential 8 (LE8) score and the incidence of four cardiovascular outcomes (ischemic heart disease, myocardial infarction, stroke, and heart failure [HF]) - separately and as a composite outcome of major adverse cardiovascular events (MACE) - in UK Biobank. 250,825 participants were included in this prospective study. Smoking, non-HDL cholesterol, blood pressure, body mass index, HbA1c, physical activity, diet, and sleep were used to create a modified version of the LE8 score. Associations between the score (both as a continuous score and as quartiles) and outcomes were investigated using adjusted Cox proportional hazard models. The potential impact fractions of two scenarios were also calculated. Over a median follow-up of 10.4 years, there were 25,068 MACE. Compared to individuals in the highest quartile of the score (healthiest), those in the lowest quartile (least healthy) had 2.07 (95% CI: 1.99; 2.16) higher risk for MACE. The highest relative risk gradient of the individual outcomes was observed for HF (HRlowest quartile: 2.67 [95% CI: 2.42; 2.94]). The magnitude of association was stronger in participants below 50 years, women, and ethnic minorities. A targeted intervention that increased, by 10-points, the score among individuals in the lowest quartile could have prevented 9.2% of MACE. Individuals with a lower LE8 score experienced more MACE, driven especially by incident HF. Our scenarios suggested that relevant interventions targeted towards those in the lowest quartile may have a greater impact than interventions producing small equal changes across all quartiles.
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Affiliation(s)
- Fanny Petermann-Rocha
- BHF Cardiovascular Research Centre. School of Cardiovascular and Metabolic Health, University of Glasgow. Glasgow, UK; Centro de Investigación Biomédica, Facultad de Medicina, Universidad Diego Portales, Santiago, Chile
| | - Salil Deo
- School of Health and Wellbeing, University of Glasgow. Glasgow, UK; Louis Stokes Cleveland VA Medical Center, Cleveland USA; Department of Surgery, Case School of Medicine, Case Western Reserve University, Cleveland USA
| | - Carlos Celis-Morales
- BHF Cardiovascular Research Centre. School of Cardiovascular and Metabolic Health, University of Glasgow. Glasgow, UK; Human Performance Laboratory, Education, Physical Activity and Health Research Unit, Universidad Católica del Maule, Talca, Chile
| | - Frederick K Ho
- School of Health and Wellbeing, University of Glasgow. Glasgow, UK
| | - Pankaj Bahuguna
- Health Economics and Health Technology Assessment, School of Health and Wellbeing, University of Glasgow Glasgow, UK
| | - David McAllister
- School of Health and Wellbeing, University of Glasgow. Glasgow, UK
| | - Naveed Sattar
- BHF Cardiovascular Research Centre. School of Cardiovascular and Metabolic Health, University of Glasgow. Glasgow, UK
| | - Jill P Pell
- School of Health and Wellbeing, University of Glasgow. Glasgow, UK.
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Parra-Soto S, Tumblety C, Araya C, Rezende LFM, Ho FK, Pell JP, Celis-Morales C. Associations of Physical Activity With Breast Cancer Risk: Findings From the UK Biobank Prospective Cohort Study. J Phys Act Health 2023; 20:272-278. [PMID: 36780904 DOI: 10.1123/jpah.2022-0437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 12/20/2022] [Accepted: 12/20/2022] [Indexed: 02/15/2023]
Abstract
PURPOSE Although physical activity (PA) has been consistently associated with breast cancer, existing evidence is limited to self-reported physical activity, which is prone to dilution bias. Therefore, this aims to examine the associations of device-measured PA domains with breast cancer risk and whether it differs by menopausal status. METHODS Prospective cohort study. Data from 48,286 women from the UK Biobank cohort were analyzed. A wrist triaxial accelerometer was used to collect physical activity data for light, moderate, vigorous, moderate to vigorous, and total PA. Cox proportional models were performed to examine the association between PA domains, menopausal status, and breast cancer risk. RESULTS Eight hundred thirty-six breast cancer cases were diagnosed during a median of 5.4 years (interquartile range: 4.7-5.9). For total PA, those in the most active quartile had a 26% lower risk of breast cancer (Hazard ratio [HR]: 0.74; 95% confidence interval [CI], 0.61-0.91) compared with those least active. Similar results were observed for light PA (HR: 0.79; 95% CI, 0.64-0.96), and moderate to vigorous PA (HR: 0.78; 95% CI, 0.64-0.96). However, moderate PA (HR: 0.73; 95% CI, 0.44-1.19) and vigorous PA (HR: 0.77; 95% CI, 0.56-1.05) was nonsignificant. No evidence of interaction between PA domains and menopause status was found (P > .10). CONCLUSION High levels of PA are associated with a lower risk of breast cancer with similar magnitude of associations observed across different intensity domains.
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Affiliation(s)
- Solange Parra-Soto
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow,United Kingdom
- Department of Nutrition and Public Health, Universidad del Bío-Bío, Chillan,Chile
| | - Craig Tumblety
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow,United Kingdom
| | - Carolina Araya
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow,United Kingdom
| | - Leandro F M Rezende
- Departamento de Medicina Preventiva, Universidade Federal do São Paulo, Escola Paulista de Medicina, São Paulo, SP,Brazil
| | - Frederick K Ho
- School of Health and Wellbeing, University of Glasgow, Glasgow,United Kingdom
| | - Jill P Pell
- School of Health and Wellbeing, University of Glasgow, Glasgow,United Kingdom
| | - Carlos Celis-Morales
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow,United Kingdom
- Human Performance Lab, Education, Physical Activity and Health Research Unit, University Católica del Maule, Talca,Chile
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Concha-Cisternas Y, Castro-Piñero J, Leiva-Ordóñez AM, Valdés-Badilla P, Celis-Morales C, Guzmán-Muñoz E. Effects of Neuromuscular Training on Physical Performance in Older People: A Systematic Review. Life (Basel) 2023; 13:life13040869. [PMID: 37109398 PMCID: PMC10147025 DOI: 10.3390/life13040869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/04/2023] [Accepted: 03/18/2023] [Indexed: 04/29/2023] Open
Abstract
This systematic review aimed to assess the available evidence on the effects of neuromuscular training on physical performance in older adults. A literature search was conducted across four databases (Psychology and Behavioral (EBSCO), Scopus, Web of Science and PubMed). The PRISMA guidelines were followed. The PEDro scale and Cochrane risk of bias tool were used to assess the quality of and risk of bias in the studies, respectively. The protocol was registered in PROSPERO (code: CRD42022319239). The outcomes were muscle strength, cardiorespiratory fitness, postural balance and gait speed. From 610 records initially found, 10 were finally included in the systematic review, involving 354 older people with a mean age of 67.3 years. Nine of them reported significant changes in at least one variable related to physical performance in the intervention compared to the control groups. The neuromuscular training caused significant improvements in postural balance, flexibility, cardiorespiratory fitness, strength power of the upper and lower limbs and autonomy. The available evidence indicates that neuromuscular training has a positive effect on some variables of physical performance, especially in postural balance; however, the methodological quality and certainty of the evidence in the available literature are limited. Therefore, a greater number of high-quality studies are required to draw definitive conclusions.
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Affiliation(s)
- Yeny Concha-Cisternas
- Escuela de Kinesiología, Facultad de Salud, Universidad Santo Tomás, Talca 3460000, Chile
| | - José Castro-Piñero
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cádiz, 11519 Puerto Real, Spain
- Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), University of Cádiz, 11009 Cádiz, Spain
| | - Ana María Leiva-Ordóñez
- Instituto de Anatomía, Histología y Patología, Facultad de Medicina, Universidad Austral de Chile, Valdivia 5090000, Chile
| | - Pablo Valdés-Badilla
- Department of Physical Activity Sciences, Faculty of Education Sciences, Universidad Católica del Maule, Talca 3460000, Chile
- Carrera de Entrenador Deportivo, Escuela de Educación, Universidad Viña del Mar, Viña del Mar 2520000, Chile
| | - Carlos Celis-Morales
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow G12 8TA, UK
- Human Performance Lab, Education, Physical Activity and Health Research Unit, University Católica del Maule, Talca 3460000, Chile
| | - Eduardo Guzmán-Muñoz
- Escuela de Kinesiología, Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca 3460000, Chile
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Zhou Z, Parra-Soto S, Boonpor J, Petermann-Rocha F, Welsh P, Mark PB, Sattar N, Pell JP, Celis-Morales C, Ho FK. Exploring the underlying mechanisms linking adiposity and cardiovascular disease: A prospective cohort study of 404,332 UK Biobank participants. Curr Probl Cardiol 2023; 48:101715. [PMID: 37004891 DOI: 10.1016/j.cpcardiol.2023.101715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 03/21/2023] [Indexed: 04/03/2023]
Abstract
BACKGROUND AND AIMS Obesity is causally associated with multiple cardiovascular outcomes but effective population measure to control obesity is limited. This study aims to decipher to which extent excess atherosclerotic cardiovascular diseases (ASCVD) and heart failure (HF) risk due to obesity can be explained by conventional risk factors. METHODS This is a prospective cohort study of 404,332 White UK Biobank participants. Participants with prior CVDs or other chronic diseases at baseline, or body mass index (BMI) <18·5 kg/m2 were excluded. Data were collected at the baseline assessment between 2006 and 2010. Linkage to death registrations and hospital admission records was used to ascertain ASCVD and HF outcomes up to late 2021. Obesity was defined as BMI ≥30 kg/m2. Candidate mediators included lipids, blood pressure, glycated haemoglobin (HbA1c), and liver and kidney function markers, which were chosen based on clinical trials and Mendelian randomisation studies. Cox proportional hazard models were used to estimate hazard ratios (HR) and their 95% confidence intervals (CIs). Mediation analysis based on g-formula was used to separately estimate the relative importance of mediators for ASCVD and HF. RESULTS Compared with people without obesity, obese people had an increased risk of ASCVD (HR 1.30, 95% CI 1.26-1.35) and HF (HR 2.04, 95% CI 1.96-2.13) after adjusting for sociodemographic and lifestyle factors and medications for cholesterol, blood pressure and insulin. The strongest mediators for ASCVD were renal function (eGFR: mediation proportion: 44.6%), blood pressure (SBP: 24.4%; DBP: 31.1%), triglycerides (19.6%), and hyperglycaemia (HbA1c 18.9%). These mediators collectively explained more excess risk of ASCVD than that of HF. CONCLUSIONS Interventions that help obese individuals to maintain healthy lipid concentrations, blood pressure, glycaemic control and kidney function could potentially alleviate a sizable proportion of the ASCVD burden. However, HF burden could not be meaningfully reduced without weight management.
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Petermann-Rocha F, Celis-Morales C, Pell JP, Ho FK. Do all vegetarians have a lower cardiovascular risk? A prospective study. Clin Nutr 2023; 42:269-276. [PMID: 36716619 DOI: 10.1016/j.clnu.2023.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 11/25/2022] [Accepted: 01/06/2023] [Indexed: 01/13/2023]
Abstract
BACKGROUND Vegetarian diets are heterogeneous and their health benefits may vary. This study aimed to compare the cardiovascular risk among vegetarian diets that meet existing health guidelines, those that do not, and diets that include red meat. METHODS 391,124 participants (55.5% women) from the UK Biobank prospective population-based study were included. Using data from a food frequency questionnaire, participants were categorised into lacto-vegetarian or meat-eaters. Then, both groups were dichotomised into a healthier and less healthy group using an unweighted score based on current UK guidelines. Ischaemic heart disease (IHD) and myocardial infarction (MI) incidence - both separately and as a composite of major adverse cardiovascular events (MACE) - were the outcomes included. Associations between types of diets and health outcomes were investigated using Cox proportional hazard models adjusted for confounder factors. RESULTS After a median follow-up of 10.4 years, there were 40,048 MACE. When the analyses were adjusted for prevalent morbidity and lifestyle factors, people who followed healthier vegetarian and meat-eater diets had 18% (95% CI: 0.73 to 0.92) and 5% (95% CI: 0.93 to 0.97) lower risk of MACE than less healthy meat-eaters. Similar patterns were identified for the individual outcomes, with the strongest association observed for MI. The cardiovaculasr risk among less healthy vegetarians and less healthy meat-eaters were not significnatly different. CONCLUSIONS Vegetarian diets are heterogeneous and the cardiovascular risk varied accordingly. Future studies should consider the overall dietary patterns of vegetarians rather than just based on meat consumption. Guidelines advocating a plant-based diet need to stress the importance of overall diet quality in addition to the reduction of meat.
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Affiliation(s)
- Fanny Petermann-Rocha
- School of Cardiovascular and Metabolic Health, University of Glasgow, United Kingdom; Centro de Investigación Biomédica, Facultad de Medicina, Universidad Diego Portales, Santiago, Chile
| | - Carlos Celis-Morales
- School of Cardiovascular and Metabolic Health, University of Glasgow, United Kingdom; Laboratorio de Rendimiento Humano, Grupo de Estudio en Educación, Actividad Física y Salud (GEEAFyS), Universidad Católica Del Maule, Talca, Chile
| | - Jill P Pell
- School of Health and Wellbeing, University of Glasgow, United Kingdom
| | - Frederick K Ho
- School of Health and Wellbeing, University of Glasgow, United Kingdom.
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Ochoa-Rosales C, Mardones L, Villagrán M, Aguayo C, Martorell M, Celis-Morales C, Ulloa N. Body Adiposity Partially Mediates the Association between FTO rs9939609 and Lower Adiponectin Levels in Chilean Children. Children 2023; 10:children10030426. [PMID: 36979984 PMCID: PMC10047575 DOI: 10.3390/children10030426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 02/13/2023] [Accepted: 02/20/2023] [Indexed: 02/25/2023]
Abstract
Children carrying the minor allele ‘A’ at the fat mass and obesity-associated protein (FTO) gene have higher obesity prevalence. We examined the link between FTO rs9939609 polymorphism and plasma adiponectin and the mediating role of body adiposity, in a cross-sectional study comprising 323 children aged 6–11 years. Adiponectin and FTO genotypes were assessed using a commercial kit and a real-time polymerase chain reaction with high-resolution melting analysis, respectively. Body adiposity included body mass index z-score, body fat percentage and waist-to-hip ratio. To investigate adiponectin (outcome) associations with FTO and adiposity, linear regressions were implemented in additive models and across genotype categories, adjusting for sex, age and Tanner’s stage. Using mediation analysis, we determined the proportion of the association adiponectin-FTO mediated by body adiposity. Lower adiponectin concentrations were associated with one additional risk allele (βadditive = −0.075 log-μg/mL [−0.124; −0.025]), a homozygous risk genotype (βAA/TT =−0.150 [−0.253; −0.048]) and a higher body mass index z-score (β = −0.130 [−0.176; −0.085]). Similar results were obtained for body fat percentage and waist-to-hip ratio. Body adiposity may mediate up to 29.8% of the FTO-adiponectin association. In conclusion, FTO rs9939609-related differences in body adiposity may partially explain lower adiponectin concentrations. Further studies need to disentangle the biological pathways independent from body adiposity.
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Affiliation(s)
- Carolina Ochoa-Rosales
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago 7941169, Chile
- Centro de Vida Saludable, Universidad de Concepción, Concepción 4070374, Chile
| | - Lorena Mardones
- Laboratorio de Ciencias Biomédicas, Facultad de Medicina, Universidad Católica de la Santísima Concepción, Concepción 4090541, Chile
| | - Marcelo Villagrán
- Laboratorio de Ciencias Biomédicas, Facultad de Medicina, Universidad Católica de la Santísima Concepción, Concepción 4090541, Chile
| | - Claudio Aguayo
- Departamento de Bioquímica Clínica e Inmunología Facultad de Farmacia, Universidad de Concepción, Concepción 4070386, Chile
| | - Miquel Martorell
- Centro de Vida Saludable, Universidad de Concepción, Concepción 4070374, Chile
- Departamento de Nutrición y Dietética, Facultad de Farmacia, Universidad de Concepción, Concepción 4070386, Chile
| | - Carlos Celis-Morales
- British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow G12 8QQ, UK
- Laboratorio de Rendimiento Humano, Grupo de Estudio en Educación, Actividad Física y Salud (GEEAFyS), Universidad Católica del Maule, Talca 3466706, Chile
- Centre of Exercise Physiology Research (CIFE), Universidad Mayor, Santiago 7500994, Chile
| | - Natalia Ulloa
- Centro de Vida Saludable, Universidad de Concepción, Concepción 4070374, Chile
- Departamento de Bioquímica Clínica e Inmunología Facultad de Farmacia, Universidad de Concepción, Concepción 4070386, Chile
- Correspondence: ; Tel.: +56-041-2661629
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Malcomson FC, Parra-Soto S, Lu L, Ho FK, Perez-Cornago A, Shams-White MM, van Zutphen M, Kampman E, Winkels RM, Mitrou P, Wiseman M, Romaguera D, Celis-Morales C, Sharp L, Mathers JC. Operationalisation of a standardised scoring system to assess adherence to the World Cancer Research Fund/American Institute for Cancer Research cancer prevention recommendations in the UK biobank. Front Nutr 2023; 10:1011786. [PMID: 36845047 PMCID: PMC9950547 DOI: 10.3389/fnut.2023.1011786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 01/26/2023] [Indexed: 02/12/2023] Open
Abstract
Introduction In 2018, The World Cancer Research Fund (WCRF)/American Institute for Cancer Research (AICR) published ten evidence-based Cancer Prevention Recommendations designed to reduce the risk of cancer via improved lifestyle behaviours. In 2019, Shams-White and colleagues created the "2018 WCRF/AICR Score" which aimed to standardise how adherence to these recommendations is assessed. The standardised scoring system includes seven of the recommendations concerning weight, physical activity and diet, with an optional eighth recommendation on breastfeeding. To promote transparency and reproducibility, the present paper describes the methodology for operationalisation of the standardised scoring system in the UK Biobank. Methods UK Biobank recruited >500,000 individuals aged 37-73 years, between 2006 and 2010. In 2021, we held a workshop with experts which aimed to reach consensus on how to operationalise the scoring system using data available within UK Biobank. We used data on anthropometric measurements, physical activity and diet to calculate adherence scores. 24 h dietary assessment data were used to measure adherence to the following recommendations: "Eat a diet rich in wholegrains, vegetables, fruit, and beans", "Limit consumption of "fast foods" and other processed foods high in fat, starches or sugars" and "Limit consumption of sugar-sweetened drinks"; food frequency questionnaire data were used to assess adherence to "Limit consumption of red and processed meat" and "Limit alcohol consumption". Participants were allocated points for meeting, partially meeting or not meeting each recommendation, using cut-offs defined in the standardised scoring system. Results At our workshop, discussions included the use of national guidelines to assess adherence to the recommendation on alcohol consumption, as well as challenges faced including defining the adapted ultra-processed food variables. A total score was calculated for 158,415 participants (mean 3.9 points, range 0-7 points). We also describe the methodology to derive a partial 5-point adherence score using data from the food frequency questionnaire in 314,616 participants. Conclusion We describe the methodology used to estimate adherence to the 2018 WCRF/AICR Cancer Prevention Recommendations for participants in the UK Biobank, including some of the challenges faced operationalising the standardised scoring system.
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Affiliation(s)
- Fiona C. Malcomson
- Human Nutrition and Exercise Research Centre, Centre for Healthier Lives, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Solange Parra-Soto
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom
| | - Liya Lu
- Centre for Cancer, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Frederick K. Ho
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Aurora Perez-Cornago
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Marissa M. Shams-White
- Risk Factor Assessment Branch, Epidemiology and Genomics Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, United States
| | - Moniek van Zutphen
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, Netherlands
- Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands
| | - Ellen Kampman
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, Netherlands
| | - Renate M. Winkels
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, Netherlands
| | - Panagiota Mitrou
- World Cancer Research Fund International, London, United Kingdom
| | - Martin Wiseman
- World Cancer Research Fund International, London, United Kingdom
| | - Dora Romaguera
- Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Madrid, Spain
| | - Carlos Celis-Morales
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom
- Human Performance Lab, Education, Physical Activity and Health Research Unit, University Católica del Maule, Talca, Chile
| | - Linda Sharp
- Centre for Cancer, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - John C. Mathers
- Human Nutrition and Exercise Research Centre, Centre for Healthier Lives, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
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Foster HM, Polz P, Gill JM, Celis-Morales C, Mair FS, O'Donnell CA. The influence of socioeconomic status on the association between unhealthy lifestyle factors and adverse health outcomes: a systematic review. Wellcome Open Res 2023. [DOI: 10.12688/wellcomeopenres.18708.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Background: Combinations of lifestyle factors (LFs) and socioeconomic status (SES) are independently associated with cardiovascular disease (CVD), cancer, and mortality. Less advantaged SES groups may be disproportionately vulnerable to unhealthy LFs but interactions between LFs and SES remain poorly understood. This review aimed to synthesise the available evidence for whether and how SES modifies associations between combinations of LFs and adverse health outcomes. Methods: Systematic review of studies that examine associations between combinations of >3 LFs and health outcomes and report data on SES influences on associations. Databases (PubMed/EMBASE/CINAHL), references, forward citations, and grey-literature were searched from inception to December 2021. Eligibility criteria were analyses of prospective adult cohorts that examined all-cause mortality or CVD or cancer mortality/incidence. Results: Six studies (n=42,467–399,537; 46.5–56.8 years old; 54.6–59.3% women) of five cohorts were included. All examined all-cause mortality; three assessed CVD/cancer outcomes. Four studies observed multiplicative interactions between LFs and SES, but in opposing directions. Two studies tested for additive interactions; interactions were observed in one cohort (UK Biobank) and not in another (NHANES). All-cause mortality HRs (95% CIs) for unhealthy LFs (versus healthy LFs) from the most advantaged SES groups ranged from 0.68 (0.32–1.45) to 4.17 (2.27–7.69). Equivalent estimates from the least advantaged ranged from 1.30 (1.13–1.50) to 4.00 (2.22–7.14). In 19 analyses (including sensitivity analyses) of joint associations between LFs, SES, and all-cause mortality, highest all-cause mortality was observed in the unhealthiest LF-least advantaged suggesting an additive effect. Conclusions: Limited and heterogenous literature suggests that the influence of SES on associations between combinations of unhealthy LFs and adverse health could be additive but remains unclear. Additional prospective analyses would help clarify whether SES modifies associations between combinations of unhealthy LFs and health outcomes. Registration: Protocol is registered with PROSPERO (CRD42020172588; 25 June 2020).
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Petermann-Rocha F, Parra-Soto S, Cid V, Venegas P, Huidobro A, Ferreccio C, Celis-Morales C. The association between walking pace and grip strength and all-cause mortality: A prospective analysis from the MAUCO cohort. Maturitas 2023; 168:37-43. [PMID: 36442346 DOI: 10.1016/j.maturitas.2022.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 10/11/2022] [Accepted: 11/10/2022] [Indexed: 11/24/2022]
Abstract
OBJECTIVE This study investigated the individual and combined association of walking pace and grip strength with all-cause mortality in Chilean adults. STUDY DESIGN 8813 participants (54.6 % women) from the MAUCO population-based cohort were included in this prospective study. MAIN OUTCOME MEASURES Individual and combined associations of grip strength (normal or low grip) and walking pace (normal or slow walking) with all-cause mortality were investigated using Cox proportional-hazard models. Analyses were adjusted for sociodemographic, lifestyle, and health-related factors. RESULTS Over a median follow-up of 4.74 years, 151 and 206 participants included in the analyses of walking pace and grip strength died. Individuals with low grip strength had a risk of dying 2.40 times (95 % CI: 1.64 to 3.51) higher than their counterparts with normal grip strength. Similar results were identified for slow walkers (HR: 1.77 [95 % CI: 1.25 to 2.50]). When the two factors were combined and the associations investigated, individuals with normal walking pace but with low grip strength had a higher risk of all-cause mortality than those with normal walking pace and normal grip strength (HR: 3.56 [95 % CI: 1.99 to 6.36]). The associations remained even after including a 1- and 2-year landmark period in the analyses. CONCLUSIONS Slow walking pace and low grip strength were associated with a higher risk of mortality (both in isolation and combined). These factors might be early markers of all-cause mortality, and should be measured more frequently in middle-aged and older adults in clinical practice.
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Affiliation(s)
- Fanny Petermann-Rocha
- Centro de Investigación Biomédica, Facultad de Medicina, Universidad Diego Portales, Santiago, Chile; BHF Cardiovascular Research Centre, School of Cardiovascular and Metabolic Health, University of Glasgow, United Kingdom.
| | - Solange Parra-Soto
- BHF Cardiovascular Research Centre, School of Cardiovascular and Metabolic Health, University of Glasgow, United Kingdom; Department of Nutrition and Public Health, Universidad del Bío-Bío, Chillán 3780000, Chile
| | - Vicente Cid
- Facultad de Medicina, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Pia Venegas
- Facultad de Medicina, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Andrea Huidobro
- Facultad de Medicina, Universidad Católica del Maule, Talca, Chile
| | - Catterina Ferreccio
- Facultad de Medicina, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Carlos Celis-Morales
- BHF Cardiovascular Research Centre, School of Cardiovascular and Metabolic Health, University of Glasgow, United Kingdom; Human Performance Lab, Education, Physical Activity and Health Research Unit, Universidad Católica del Maule, Talca 3466706, Chile
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Chu W, Lynskey N, Iain-Ross J, Pell JP, Sattar N, Ho FK, Welsh P, Celis-Morales C, Petermann-Rocha F. Identifying the Biomarker Profile of Pre-Frail and Frail People: A Cross-Sectional Analysis from UK Biobank. Int J Environ Res Public Health 2023; 20:2421. [PMID: 36767787 PMCID: PMC9915970 DOI: 10.3390/ijerph20032421] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/20/2023] [Accepted: 01/27/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE This study aimed to compare the biomarker profile of pre-frail and frail adults in the UK Biobank cohort by sex. METHODS In total, 202,537 participants (67.8% women, aged 37 to 73 years) were included in this cross-sectional analysis. Further, 31 biomarkers were investigated in this study. Frailty was defined using a modified version of the Frailty Phenotype. Multiple linear regression analyses were performed to explore the biomarker profile of pre-frail and frail individuals categorized by sex. RESULTS Lower concentrations of apoA1, total, LDL, and HDL cholesterol, albumin, eGFRcys, vitamin D, total bilirubin, apoB, and testosterone (differences ranged from -0.30 to -0.02 per 1-SD change), as well as higher concentrations of triglycerides, GGT, cystatin C, CRP, ALP, and phosphate (differences ranged from 0.01 to 0.53 per 1-SD change), were identified both in pre-frail and frail men and women. However, some of the associations differed by sex. For instance, higher rheumatoid factor and urate concentrations were identified in pre-frail and frail women, while lower calcium, total protein, and IGF-1 concentrations were identified in pre-frail women and frail women and men. When the analyses were further adjusted for CRP, similar results were found. CONCLUSIONS Several biomarkers were linked to pre-frailty and frailty. Nonetheless, some of the associations differed by sex. Our findings contribute to a broader understanding of the pathophysiology of frailty as currently defined.
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Affiliation(s)
- Wenying Chu
- BHF Cardiovascular Research Centre, School of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G12 8TA, UK
| | - Nathan Lynskey
- BHF Cardiovascular Research Centre, School of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G12 8TA, UK
| | - James Iain-Ross
- BHF Cardiovascular Research Centre, School of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G12 8TA, UK
| | - Jill P. Pell
- School of Health and Wellbeing, University of Glasgow, Glasgow G12 8RZ, UK
| | - Naveed Sattar
- BHF Cardiovascular Research Centre, School of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G12 8TA, UK
| | - Frederick K. Ho
- School of Health and Wellbeing, University of Glasgow, Glasgow G12 8RZ, UK
| | - Paul Welsh
- School of Health and Wellbeing, University of Glasgow, Glasgow G12 8RZ, UK
| | - Carlos Celis-Morales
- School of Health and Wellbeing, University of Glasgow, Glasgow G12 8RZ, UK
- Laboratorio de Rendimiento Humano, Grupo de Estudio en Educación, Actividad Física y Salud (GEEAFyS), Universidad Católica del Maule, Talca 3466706, Chile
| | - Fanny Petermann-Rocha
- BHF Cardiovascular Research Centre, School of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G12 8TA, UK
- Centro de Investigación Biomédica, Facultad de Medicina, Universidad Diego Portales, Santiago 8370068, Chile
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Diaz-Toro F, Nazar G, Troncoso C, Concha-Cisternas Y, Leiva-Ordoñez AM, Martinez-Sanguinetti MA, Parra-Soto S, Lasserre-Laso N, Cigarroa I, Mardones L, Vásquez-Gómez J, Petermann-Rocha F, Diaz-Martinez X, Celis-Morales C. Frailty Index as a Predictor of Mortality in Middle-Aged and Older People: A Prospective Analysis of Chilean Adults. Int J Environ Res Public Health 2023; 20:1195. [PMID: 36673951 PMCID: PMC9859421 DOI: 10.3390/ijerph20021195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 01/04/2023] [Accepted: 01/05/2023] [Indexed: 06/17/2023]
Abstract
We aimed to investigate the association between frailty status and all-cause mortality in middle-aged and older people. We included 2661 individuals aged ≥ 35 from the Chilean National Health Survey 2009−2010. Mortality was determined through linkage with the Chilean Civil Registry and Identification. A 36-item frailty index (FI) was used to assess the frailty status. Associations between frailty status and all-cause mortality were assessed using Kaplan−Meier and Cox proportional hazard models adjusted for sociodemographic and lifestyle factors. A non-linear association was investigated using penalized cubic splines fitted in the Cox models. During an 8.9 median follow-up (interquartile range of 8.6−9.0), 308 individuals died (11.5%). Lower survival rates were observed in frail individuals compared to pre-frail and robust people (log-rank < 0.001). Compared with robust individuals, frail people had a higher mortality risk (HR: 2.35 [95% CI: 1.57 to 3.51]). Frail middle-aged individuals had a higher risk of dying independently of major risk factors.
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Affiliation(s)
- Felipe Diaz-Toro
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA
- Facultad de Enfermeria, Universidad Andres Bello, Santiago 7550196, Chile
| | - Gabriela Nazar
- Departamento de Psicología y Centro de Vida Saludable, Universidad de Concepción, Concepción 4030000, Chile
| | - Claudia Troncoso
- Centro de Investigación en Educación y Desarrollo (CIEDE-UCSC), Departamento de Salud Pública, Facultad de Medicina, Universidad Católica de la Santísima Concepción, Concepción 4070129, Chile
| | - Yeny Concha-Cisternas
- Escuela de Kinesiología, Facultad de Salud, Universidad Santo Tomás, Talca 8370003, Chile
- Pedagogía en Educación Física, Facultad de Educación, Universidad Autónoma de Chile, Talca 7500912, Chile
| | - Ana Maria Leiva-Ordoñez
- Instituto de Anatomía, Histología y Patología, Facultad de Medicina, Universidad Austral de Chile, Valdivia 5110566, Chile
| | | | - Solange Parra-Soto
- BHF Glasgow Cardiovascular Research Centre, School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow G12 8QQ, UK
| | - Nicole Lasserre-Laso
- Escuela de Nutrición y Dietética, Facultad de Salud, Universidad Santo Tomás, Los Ángeles 4440000, Chile
| | - Igor Cigarroa
- Escuela de Kinesiología, Facultad de Salud, Universidad Santo Tomás, Los Ángeles 4440000, Chile
| | - Lorena Mardones
- Laboratorio de Ciencias Biomédicas, Facultad de Medicina, Universidad Católica de la Santísima Concepción, Concepción 4090541, Chile
| | - Jaime Vásquez-Gómez
- Centro de Investigación de Estudios Avanzados del Maule, Universidad Católica del Maule, Talca 3460000, Chile
- Laboratorio de Rendimiento Humano, Education, Physical Activity and Health Research Unit, Universidad Católica del Maule, Talca 3466706, Chile
| | - Fanny Petermann-Rocha
- BHF Glasgow Cardiovascular Research Centre, School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow G12 8QQ, UK
- Centro de Investigación Biomédica, Facultad de Medicina, Universidad Diego Portales, Santiago 8370068, Chile
| | - Ximena Diaz-Martinez
- Grupo de Investigación Calidad de Vida, Universidad del Biobío, Chillán 4300818, Chile
| | - Carlos Celis-Morales
- BHF Glasgow Cardiovascular Research Centre, School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow G12 8QQ, UK
- Laboratorio de Rendimiento Humano, Education, Physical Activity and Health Research Unit, Universidad Católica del Maule, Talca 3466706, Chile
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Diaz-Toro F, Petermann-Rocha F, Lynskey N, Nazar G, Cigarroa I, Troncoso Y Concha-Cisternas C, Leiva-Ordoñez AM, Martinez-Sanguinetti MA, Parra-Soto S, Celis-Morales C. Frailty in Chile: Development of a Frailty Index Score Using the Chilean National Health Survey 2016-2017. J Frailty Aging 2023; 12:97-102. [PMID: 36946704 DOI: 10.14283/jfa.2023.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND The Frailty Index (FI) is used to quantify and summarize vulnerability status in people. In Chile, no development and assessment of a FI have been explored. OBJECTIVE To develop and evaluate a FI using representative data from Chilean adults aged 40 years and older stratified by sex. DESIGN Cross-sectional study. SETTING National representative data from the Chilean National Health Survey 2016-2017 (CNHS 2016-2017). PARTICIPANTS 3,036 participants older than 40 years with complete data for all variables. MEASUREMENTS A 49-item FI was developed and evaluated. This FI included deficits from comorbidities, functional limitations, mental health status, physical activity, anthropometry, medications, and falls. A score between 0 and 1 was calculated for each person. Descriptive statistics and linear regression models were employed to evaluate the FI's performance in the population. Comparative analyses were carried out to evaluate the FI score by age (1<60 and ≥ 60 years). RESULTS The mean FI score was 0.15 (SD:0.09), with a 99% upper limit of 0.46. Scores were greater in women than men (0.17 [SD:0.09]) vs. 0.12 [0.08]); in people older than 80 years (0.22 [0.11]), and in people with ≤8 years of education (0.18 [0.10]) compared with those with >12 years (0.12 [0.08]). The average age-related increase in the FI was 2.3%. When a cut-off point ≥ 0.25 was applied, the prevalence of frail individuals was 11.8% (95% CI: 10.0 to 13.8) in the general population. The prevalence was higher in women 15.9% [95% CI: 13.3 to 18.9] than men 7.4% [95% CI: 5.3 to 10.1]. In a comparative analysis by age, higher FI mean scores and prevalence of frail were observed in people ≥ 60 than younger than 60. CONCLUSIONS The mean FI score and frailty prevalence were higher in women than men, in people with fewer years of formal education, and incremented markedly with age. This FI can be used for early detection of frailty status focusing on women and middle-aged people as a strategy to delay or prevent frailty-related consequences.
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Affiliation(s)
- F Diaz-Toro
- Fanny Petermann-Rocha, Ph.D, Centro de Investigación Biomédica, Facultad de Medicina, Universidad Diego Portales, Santiago, Chile, , Phone number: +56 2 26768968
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Lithgow H, Johnston L, Ho FK, Celis-Morales C, Cobley J, Raastad T, Hunter AM, Lees JS, Mark PB, Quinn TJ, Gray SR. Protocol for a randomised controlled trial to investigate the effects of vitamin K2 on recovery from muscle-damaging resistance exercise in young and older adults-the TAKEOVER study. Trials 2022; 23:1026. [PMID: 36539791 PMCID: PMC9764575 DOI: 10.1186/s13063-022-06937-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 11/16/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Regular participation in resistance exercise is known to have broad-ranging health benefits and for this reason is prominent in the current physical activity guidelines. Recovery after such exercise is important for several populations across the age range and nutritional strategies to enhance recovery and modulate post-exercise physiological processes are widely studied, yet effective strategies remain elusive. Vitamin K2 supplementation has emerged as a potential candidate, and the aim of the current study, therefore, is to test the hypothesis that vitamin K2 supplementation can accelerate recovery, via modulation of the underlying physiological processes, following a bout of resistance exercise in young and older adults. METHODS The current study is a two-arm randomised controlled trial which will be conducted in 80 (40 young (≤40 years) and 40 older (≥65 years)) adults to compare post-exercise recovery in those supplemented with vitamin K2 or placebo for a 12-week period. The primary outcome is muscle strength with secondary outcomes including pain-free range of motion, functional abilities, surface electromyography (sEMG) and markers of inflammation and oxidative stress. DISCUSSION Ethical approval has been granted by the College of Medical Veterinary and Life Sciences Ethical Committee at the University of Glasgow (Project No 200190189) and recruitment is ongoing. Study findings will be disseminated through a presentation at scientific conferences and in scientific journals. TRIAL REGISTRATION ClinicialTrials.gov NCT04676958. Prospectively registered on 21 December 2020.
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Affiliation(s)
- Hannah Lithgow
- grid.8756.c0000 0001 2193 314XSchool of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, G12 8TA UK
| | - Lynsey Johnston
- grid.8756.c0000 0001 2193 314XSchool of Life Sciences, University of Glasgow, Glasgow, UK
| | - Frederick K. Ho
- grid.8756.c0000 0001 2193 314XSchool of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Carlos Celis-Morales
- grid.8756.c0000 0001 2193 314XSchool of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, G12 8TA UK
| | - James Cobley
- grid.23378.3d0000 0001 2189 1357Division of Biomedical Sciences, University of Highlands and Islands, Inverness, UK
| | - Truls Raastad
- grid.412285.80000 0000 8567 2092Department of Physical Performance, Norwegian School of Sports Science, Oslo, Norway
| | - Angus M. Hunter
- grid.12361.370000 0001 0727 0669Department of Sprots Science, Nottingham Trent University, Nottingham, UK
| | - Jennifer S. Lees
- grid.8756.c0000 0001 2193 314XSchool of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, G12 8TA UK
| | - Patrick B. Mark
- grid.8756.c0000 0001 2193 314XSchool of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, G12 8TA UK
| | - Terry J. Quinn
- grid.8756.c0000 0001 2193 314XSchool of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, G12 8TA UK
| | - Stuart R. Gray
- grid.8756.c0000 0001 2193 314XSchool of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, G12 8TA UK ,grid.419313.d0000 0000 9487 602XDepartment of Health Promotion and Rehabilitation, Lithuanian Sports University, Kaunas, Lithuania
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Concha-Cisternas Y, Castro-Piñero J, Vásquez J, Martorell M, Cigarroa I, Petermann-Rocha F, Parra-Soto S, Poblete F, Matus-Castillo C, Garrrido-Méndez Á, Martínez- Sanguinetti MA, Nazar G, Leiva-Ordoñez AM, Troncoso-Pantoja C, Diaz-Martínez X, Celis-Morales C. Asociación entre velocidad de marcha y deterioro cognitivo en personas mayores: resultados de la Encuesta Nacional de Salud 2016-2017. sun 2022. [DOI: 10.14482/sun.38.3.155.67] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Antecedentes: La velocidad de la marcha podría considerarse un marcador temprano de riesgo de deterioro cognitivo en personas mayores. Objetivo: Determinar la asociación entre velocidad de la marcha y sospecha de deterioro cognitivo en población mayor chilena. Métodos:Se incluyeron 1.788 personas mayores de la Encuesta Nacional de Salud (ENS) 2016-2017 que tenían información sobre velocidad de marcha y sospecha de deterioro cognitivo. La velocidad de la marcha fue auto-reportada y categorizada como marca lenta, normal y rápida. Sospecha de deterioro cognitivo fue evaluado a través del cuestionario Mini-Mental abreviado. La asociación entre marcha y deterioro cognitivo fue investigada mediante análisis de regresión logística. Resultados: En comparación a las personas mayores que reportaron una velocidad de marcha rápida, aquellas que reportaron una marcha lenta presentaron 2,67 veces mayor probabilidad de tener deterioro cognitivo (OR: 2,67 [95% IC:1,62; 4,42], p<0,001). Al ajustar los modelos por variables de confusión socio-demográficas, estilos de vida y salud, la asociación disminuyó, pero permaneció significativa (OR: 1,78 [95% IC:1,00; 3,17], p=0,047). Mientras que las personas mayores que reportaron tener una velocidad de marcha normal no presentaron asociación con deterioro cognitivo. Conclusión: Personas mayores que reportan una velocidad de marcha lenta presentaron una mayor probabilidad de sospecha de deterioro cognitivo. Considerando que el deterioro cognitivo es un síndrome geriátrico con alta prevalencia en población mayor, existe la necesidad de enfatizar en estrategias para un diagnóstico temprano, por lo cual, la velocidad de marcha podría ser un instrumento útil
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Troncoso-Pantoja C, Lanuza F, Martínez-Sanguinetti MA, Leiva-Ordoñez AM, Ramírez-Alarcón K, Martorell M, Labraña AM, Parra-Soto S, Lasserre-Laso N, Nazar G, Celis-Morales C, Petermann-Rocha F. [Compliance with the Dietary Guidelines in Chilean adolescents: a cross-sectional study of the Chilean National Health Survey 2016-2017]. Andes Pediatr 2022; 93:878-888. [PMID: 37906805 DOI: 10.32641/andespediatr.v93i6.4191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 06/09/2022] [Indexed: 11/02/2023]
Abstract
In Chile, compliance with the Food-Based Dietary Guidelines (GABA) ensures an adequate and ba lanced diet. OBJECTIVE To determine compliance with five GABA recommendations and their asso ciations with anthropometric, lifestyle, and metabolic variables, in adolescents aged between 15 and 19 years who participated in the Chilean National Health Survey 2016-2017. SUBJECTS AND METHOD Cross-sectional study including 355 adolescents. Participants were divided into four groups (fulfilled 0, 1, 2, or ≥ 3 recommendations) using five messages from the GABA (consumption of legumes, fish, dairy products, water, and fruits and vegetables). Associations between GABA and outcome variables (weight, body mass index, waist circumference, physical activity, sleep, and metabolic variables) were investigated using linear regression analyses adjusted by sociodemographic confounders. RESULTS 5.6% of the adolescents met three or more GABA recommendations. Of the recommendations mea sured, the consumption of water (85%) and legumes (78.7%) presented greater compliance, showing differences between women and men regarding the consumption of legumes (58.6% vs. 86.4%), wa ter (69.6% vs. 91%), and dairy products (92.9% vs. 39.1%). Adolescents with higher compliance with GABA had a better concentration of lower glycemia (p = 0.025). There were no other significant asso ciations between lifestyle and anthropometric measurements. CONCLUSIONS Adolescents who partici pated in this study presented difficulties in adhering to GABA recommendations, thus compromising the maintenance of healthy lifestyles.
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Affiliation(s)
- Claudia Troncoso-Pantoja
- Departamento de Salud Pública, Facultad de Medicina, Universidad Católica de la Santísima Concepción, Concepción, Chile
| | - Fabián Lanuza
- Department of Nutrition, Food Sciences and Gastronomy, Faculty of Pharmacy and Food Scien ces, University of Barcelona, Barcelona, Spain
| | | | - Ana María Leiva-Ordoñez
- Instituto de Anatomía, Histología y Patología, Facultad de Medicina, Universidad Austral de Chile, Valdivia, Chile
| | - Karina Ramírez-Alarcón
- Departamento de Nutrición y Dietética, Facultad de Farmacia, Universidad de Concepción, Concepción, Chile
| | - Miquel Martorell
- Departamento de Nutrición y Dietética, Facultad de Farmacia, Universidad de Concepción, Concepción, Chile
| | - Ana María Labraña
- Departamento de Nutrición y Dietética, Facultad de Farmacia, Universidad de Concepción, Concepción, Chile
| | - Solange Parra-Soto
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Nicole Lasserre-Laso
- Escuela de Nutrición y Dietética, Facultad de Salud, Universidad Santo Tomás, Los Ángeles, Chile
| | - Gabriela Nazar
- Departamento de Psicología, Facultad de Ciencias Sociales, Universidad de Concepción, Concepción, Chile
| | | | - Fanny Petermann-Rocha
- School of Cardiovascular & Metabolic health, University of Glasgow, Glasgow, United Kingdom
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Concha-Cisternas Y, Castro-Piñero J, Petermann-Rocha F, Troncoso-Pantoja C, Díaz X, Cigarroa I, Martorell M, Martínez-Sanguinetti MA, Nazar G, Leiva-Ordoñez AM, Celis-Morales C. [Association between educational level and suspicion of cognitive imparirment in Chilean older people]. Rev Med Chil 2022; 150:1575-1584. [PMID: 37906778 DOI: 10.4067/s0034-98872022001201575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 10/07/2022] [Indexed: 11/02/2023]
Abstract
BACKGROUND A low education level has been associated with cognitive impairment in older adults. AIM To determine the association between educational attainment and suspicion of cognitive imparirment in older Chilean population. MATERIAL AND METHODS Data from 2,005 adults aged ≥ 60 years assessed during 2016-2017 Chilean National Health Survey were included. Education was self-reported and categorized as primary: ≤ 8 years; secondary: 9 to 12 years and beyond secondary: > 12 years. suspicion of cognitive imparirment was assessed with the Mini-Mental questionnaire. RESULTS Men and women with low education attainment had a higher prevalence of cognitive impairment (33% [95% confidence intervals (CI): 24; 41] and 27% [95% CI: 21; 33], respectively). Men who reported less schooling (≤ 8 years) were more likely to be at risk of suspicion of cognitive imparirment (Odds ratio (OR): 4.53 [95% CI: 1.10, 18.62]) compared to their peers. Women showed a substantially higher magnitude of association than men. The probability of suspicion of cognitive imparirment increased 9-times (OR: 9.96 [95% CI: 1.24; 79.6]) for 9-12 years and 18-times for ≤ 8 years of education (OR: 18.8 [95% CI: 2.42; 146.1]) compared to women with higher education. CONCLUSIONS Older adults with low education attainment had an increased likelihood of developing suspicion of cognitive imparirment. However, the risk differs by sex, being higher in women than men.
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Affiliation(s)
| | - José Castro-Piñero
- Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Puerto Real, Spain
| | - Fanny Petermann-Rocha
- Centro de Investigación Biomédica, Facultad de Medicina, Universidad Diego Portales, Santiago, Chile
| | - Claudia Troncoso-Pantoja
- Departamento de Salud Pública, Facultad de Medicina, Universidad Católica de la Santísima Concepción, Concepción, Chile
| | - Ximena Díaz
- Escuela de Pedagogía en Educación Física, Facultad de Educación y Humanidades, Universidad del Biobio, Chile
| | - Igor Cigarroa
- Escuela de Kinesiología, Facultad de Salud, Universidad Santo Tomás, Chile
| | - Miquel Martorell
- Departamento de Nutrición y Dietética, Facultad de Farmacia, Universidad de Concepción, Concepción, Chile
| | | | - Gabriela Nazar
- Centro de Vida Saludable, Universidad de Concepción, Concepción, Chile
| | - Ana María Leiva-Ordoñez
- Instituto de Anatomía, Histología y Patología, Facultad de Medicina, Universidad Austral de Chile, Valdivia, Chile
| | - Carlos Celis-Morales
- Centro de Investigaciones en Fisiología del Ejercicio, Universidad Mayor, Santiago, Chile
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Malcomson FC, Parra-Soto S, Lu L, Ho F, Celis-Morales C, Sharp L, Mathers JC. Socioeconomic differences in adherence to the World Cancer Research Fund Cancer Prevention Recommendations in the UK Biobank cohort. Lancet 2022; 400 Suppl 1:S60. [PMID: 36930007 DOI: 10.1016/s0140-6736(22)02270-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND The combined incidence rate of all cancers is higher in deprived population groups than in least-deprived groups. Approximately 40% of cancers in the UK are attributable to lifestyle risk factors, such as smoking and obesity, which are also socioeconomically patterned, and which suggests that public health strategies for primary cancer prevention might need to be tailored according to socioeconomic status. The World Cancer Research Fund and American Institute for Cancer Research's Cancer Prevention Recommendations aim to reduce cancer risk. We investigated socioeconomic status differences in adherence to these recommendations within the cohort of the UK Biobank prospective study. METHODS We used data from participants in the UK Biobank prospective cohort study recruited between 2006 and 2010. Socioeconomic status was assessed by means of the Townsend deprivation index and participants were categorised according to deprivation quartiles. Scores for adherence to the Cancer Prevention Recommendations were calculated from dietary, physical activity, and body composition data via the recommended standardised scoring system, ranging from 0 (unhealthier lifestyle) to 7 (healthier lifestyle) points. Regression models were run to investigate associations between socioeconomic status and total score, adjusting for age, sex, ethnicity, and smoking status. Associations between adherence to individual recommendations and socioeconomic status were investigated using chi-square tests. FINDINGS Data from 150 649 participants (median age 57 years [IQR 50-63]; 79 322 [53%] women and 71 327 [47%] men) were included. The mean total adherence score was 3·58 points (SD 1·04). Adherence score was not associated with socioeconomic status (p=0·13), but was significantly related to age, sex, ethnicity, and smoking status (p<0·0001). Adherence to the recommendations for bodyweight, physical activity, and intake of fruit, vegetables, and dietary fibre was lower for the most deprived group (p<0·0001). In contrast, less deprived participants were less likely to meet the recommendations for the intake of alcohol, red and processed meat, ultra-processed foods, and sugary drinks (p<0·0001) INTERPRETATION: Our findings provide evidence on which specific recommendations for cancer prevention could be tailored, or targeted, towards those in different socioeconomic status groups. FUNDING Wereld Kanker Onderzoek Fonds (grant number IIG_FULL_2020_032), as part of the World Cancer Research Fund International Grant Programme.
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Affiliation(s)
- Fiona C Malcomson
- Human Nutrition and Exercise Research Centre, Centre for Healthier Lives, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Solange Parra-Soto
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK; British Heart Foundation Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Liya Lu
- Centre for Cancer, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Frederick Ho
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Carlos Celis-Morales
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK; Education, Physical Activity and Health Research Unit, University Católica del Maule, Talca, Chile
| | - Linda Sharp
- Centre for Cancer, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - John C Mathers
- Human Nutrition and Exercise Research Centre, Centre for Healthier Lives, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.
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Cabanas-Sánchez V, Lynskey N, Ho FK, Pell J, Celis-Morales C. Physical activity and risk of depression: does the type and number of activities matter? Lancet 2022; 400 Suppl 1:S27. [PMID: 36929970 DOI: 10.1016/s0140-6736(22)02237-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Depression is ranked as the leading cause of global disability. Physical activity has been identified as a relevant strategy to reduce the incidence of depression. However, specific aspects of physical activity (eg, type of activity or combination) in decreasing the risk of depression have been underexplored. We aimed to investigate the associations of the type of activity, the number of activities participated in, and the combination of different activity types with the risk of depression onset. METHODS We included 161 023 participants aged 38-70 years from the UK Biobank study. At baseline, participants reported their participation in walking, light do-it-yourself (DIY) activities, heavy DIY activities, sports, and other exercises. Depression onset was extracted from primary care and hospital admission records. Cox proportional models were performed, with a 2-year landmark analysis. Analyses were controlled by sociodemographic, lifestyle, and health-related covariables, as well as by total time in physical activity and frequency of physical activity. FINDINGS A total of 88 723 (55·1%) of 161 023 participants were women and 72 300 (44·9%) were men. 5401 (3·4%) of 161 023 participants developed depression over a median follow-up of 10·01 years (IQR 9·30-10·83). Compared with no physical activity, the hazard ratio (HR) for depression onset was 0·79 (95% CI 0·71-0·88) for participation in walking, 0·81 (0·72-0·91) for light DIY, 0·72 (0·63-0·82) for heavy DIY, 0·62 (0·49-0·78) for sports, and 0·73 (0·65-0·82) for others exercises. The risk of depression decreased by 19% (95% CI 10-27) in those who engaged in one activity, 25% (16-33) in two activities, 31% (21-39) in three activities, 41% (31-49) in four activities, and 58% (44-69) in five activities. Among the ten most frequent combinations, walking for pleasure, light DIY, heavy DIY, and other exercises showed the lowest risk for depression onset (HR 0·57 [95% CI 0·48-0·68]). INTERPRETATION Participation in low-intensity activities, such as walking or light DIY, was associated with a lower risk of depression in comparison with no physical activity participation. Encouraging people to combine different physical activities could lower the risk of depression further. FUNDING UK Biobank.
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Affiliation(s)
- Verónica Cabanas-Sánchez
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK; IMDEA Food Institute, The Campus of International Excellence UAM+CSIC, Madrid, Spain
| | - Nathan Lynskey
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Frederick K Ho
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Jill Pell
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Carlos Celis-Morales
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK; Human Performance Lab, Education, Physical Activity and Health Research Unit, Universidad Católica del Maule, Talca, Chile.
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Foster HME, Gill JMR, Jani BD, Celis-Morales C, Lee D, Mair FS, O'Donnell CA. Associations between a weighted health behaviour score, socioeconomic status, and all-cause mortality in UK Biobank cohort: a prospective analysis. Lancet 2022; 400 Suppl 1:S37. [PMID: 36929981 DOI: 10.1016/s0140-6736(22)02247-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Unhealthy behaviours are associated with disproportionate mortality among socioeconomically deprived populations. Previous studies exploring that disproportionate harm do not examine weighted scores, or examine few behaviours. We aimed to create an extended weighted health behaviour score and examine the effect of socioeconomic status on the association between score and all-cause mortality. METHODS Data was sourced from the UK Biobank population cohort, recruited in 2006-10. The main exposures included in the analysis were 11 health behaviours (baseline self-report): smoking status, alcohol consumption, physical activity, time spent watching television, sleep duration, added salt in diet, social isolation, intake of red meat, intake of processed meat, intake of oily fish, and intake of fruit and vegetables. Behaviours were classified as healthy or unhealthy according to national guidelines or latest evidence. Socioeconomic deprivation was measured with the Townsend deprivation index. Cox proportional hazard models of health behaviour data were prospectively linked to death registries to examine associations between health behaviours and all-cause mortality. Models were adjusted for demographics and health at baseline. Mortality associated with each behaviour alone was used to determine score weighting. For sensitivity analysis, we explored associations between weighted lifestyle score and all-cause mortality stratified by sex and ethnicity. FINDINGS The analysis included 229 107 participants with complete data. Median age was 53 years (IQR 47-60) for 119 634 (52·2%) women and 54 years (47-60) for 109 473 (47·8%) men. Over a median follow-up of 11·9 years (IQR 11.1-12.6), 9379 (4·1%) participants died. Compared with having no unhealthy behaviours, each behaviour was positively associated with all-cause mortality. Smoking (hazard ratio [HR] 2·47 [95% CI 2·25-2·70]) and social isolation (1·69 [1·54-1·86]) were associated with notably higher mortality. A weighted score was created by ascribing one point to each 40% increment in risk (four points for smoking, two points for social isolation, and one points for each of all other behaviours). A dose-response increment for all-cause mortality HR was noted with each additional point of weighted score. Associations were stronger in more deprived tertiles. With least deprived and lowest score as reference, HRs for highest scores were 2·22 (95% CI 1·72-2·86) in the least deprived and 4·10 (3·62-4·65) in the most deprived. An additive interaction between sex and lifestyle score for all-cause mortality was suggested by the data; men had slightly higher HRs at each level of the lifestyle score. However, a statistical test for interaction on a multiplicative scale was not significant. No evidence was found of interaction (either additive or multiplicative) between ethnicity and lifestyle score. INTERPRETATION An extended weighted health behaviour score has strong associations with mortality, and associations are stronger in more deprived participants. Weighted health behaviour scores that account for socioeconomic deprivation could convey personalised risk and inform healthy living policy. Further work with adequate numbers of participants from minority ethnic groups is required to make more accurate estimates of mortality associated with a weighted health behaviour score in these populations. FUNDING HMEF is supported by a Medical Research Council Clinical Research Training Fellowship (grant number MR/T001585/1), which covered the costs of accessing the data herein.
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Affiliation(s)
- Hamish M E Foster
- General Practice and Primary Care, School of Health and Wellbeing, University of Glasgow, Glasgow, UK.
| | - Jason M R Gill
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
| | - Bhautesh D Jani
- General Practice and Primary Care, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Carlos Celis-Morales
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
| | - Duncan Lee
- College of Medical, Veterinary and Life Sciences, and School of Mathematics and Statistics, University of Glasgow, Glasgow, UK
| | - Frances S Mair
- General Practice and Primary Care, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Catherine A O'Donnell
- General Practice and Primary Care, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
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Foster HME, Gill JMR, Jani BD, Celis-Morales C, Lee D, Mair FS, O'Donnell CA. Which combinations of health behaviours are associated with highest risk? An exploration of the UK Biobank population cohort. Lancet 2022; 400 Suppl 1:S38. [PMID: 36929982 DOI: 10.1016/s0140-6736(22)02248-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Combinations of unhealthy behaviours are associated with greater mortality than single behaviours, but some combinations might have stronger associations than others. High-risk combinations might be more prevalent among socioeconomically deprived populations. We examined associations between combinations of 11 unhealthy behaviours and mortality and explored socioeconomic distributions of high-risk combinations. METHODS We used the UK Biobank population cohort (n=502 459; aged 37-73 years) recruited between 2006 and 2010. Analysis included 229 197 participants with complete data. Main exposures were any combination of smoking, alcohol, physical activity, television time, sleep, added salt, social isolation, intake of red meat, processed meat, oily fish, and fruit and vegetables (each classified as healthy or unhealthy via guidelines or latest evidence). Townsend index was used to explore socioeconomic distribution. Cox proportional hazard models were used to examine associations between behaviours and all-cause mortality. Models were adjusted for demographic, health, and socioeconomic factors. FINDINGS Over a median follow-up of 11·6 years, 9739 (4·2%) of 229 197 participants died. From 716 unique combinations, 77 (11%) were associated with mortality with hazard ratios (HRs) greater than that for smoking alone (2·31 [95% CI 2·11-2·53]); HRs ranged from 9·44 to 2·34. Of these 77 high-risk combinations, smoking featured in 61 (79%), low fruit and vegetables in 45 (58%), and low oily fish in 41 (53%). All combinations featuring social isolation (18 [23%] of 77) had HRs greater than 3·00. Participants with high-risk combinations had greater deprivation scores than those with no unhealthy behaviours. Median deprivation scores of the ten highest risk combinations ranged from -2·0 to 2·1, whereas for participants with no unhealthy behaviours the score was -2·5. Examining women and men separately resulted in similar findings. Examination of ethnic differences was severely limited by small numbers of participants in minority ethnic groups. INTERPRETATION Many unique unhealthy behaviour combinations are strongly associated with mortality and high-risk combinations are more prevalent among more deprived populations than among more affluent populations. Exploring unique combinations of a wide range of health behaviours can identify high-risk populations. Future work with adequately sampled minority ethnic groups is required to examine high-risk combinations by ethnicity. Supporting healthy living in deprived populations, including tackling structural barriers to health, could address a wide range of health behaviours in combination. FUNDING UK Medical Research Council.
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Affiliation(s)
- Hamish M E Foster
- General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK.
| | - Jason M R Gill
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Bhautesh D Jani
- General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Carlos Celis-Morales
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Duncan Lee
- College of Medical, Veterinary and Life Sciences, and School of Mathematics and Statistics, University of Glasgow, Glasgow, UK
| | - Frances S Mair
- General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Catherine A O'Donnell
- General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
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Nazar G, Alcover CM, Lanuza F, Labraña AM, Ramírez-Alarcón K, Troncoso-Pantoja C, Leiva AM, Celis-Morales C, Petermann-Rocha F. Association between bodyweight perception, nutritional status, and weight control practices: A cross-sectional analysis from the Chilean Health Survey 2016–2017. Front Psychol 2022; 13:984106. [PMID: 36237703 PMCID: PMC9552699 DOI: 10.3389/fpsyg.2022.984106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 08/15/2022] [Indexed: 11/18/2022] Open
Abstract
This research aimed (1) to examine the agreement between body mass index (BMI)-based nutritional status and perceived nutritional status overall and by socio-demographic factors and (2) to state the association between the accuracy of weight perception and weight control practices in the Chilean adult population. A population-based cross-sectional study was carried out with 5,192 Chilean adult participants from the Chilean National Health Survey 2016–2017. Agreement between BMI-based weight status and body weight perception for the total sample and across subgroups was determined using the weighted kappa coefficient. The agreement between BMI-based and perceived nutritional status of the total sample was fair (kappa = 0.38). A higher rate of weight perception accuracy was identified in women, younger respondents, and participants with higher education, a higher income, and from urban areas than their counterparts. Respondents with overweight or obesity tended to underestimate their nutritional status. Actions to lose weight were higher in those who had the right perception of their overweight/obesity condition and those who overestimated their body weight, regardless of their nutritional status. In all groups, weight loss behaviors were more related to the perceived than the BMI-based nutritional status. The consequences of accurate perception of the nutritional status are discussed including its effects on body weight and mental health.
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Affiliation(s)
- Gabriela Nazar
- Departamento de Psicología y Centro de Vida Saludable, Universidad de Concepción, Concepción, Chile
- *Correspondence: Gabriela Nazar,
| | - Carlos-María Alcover
- Departamento de Psicología, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Madrid, Spain
| | - Fabián Lanuza
- Biomarkers and Nutrimetabolomics Laboratory, Department of Nutrition, Food Sciences and Gastronomy, Food Technology Reference Net (XIA), Faculty of Pharmacy and Food Sciences, Nutrition and Food Safety Research Institute (INSA), University of Barcelona, Barcelona, Spain
- Facultad de Medicina, Centro de Epidemiología Cardiovascular y Nutricional (EPICYN), Facultad de Medicina, Universidad de La Frontera, Temuco, Chile
| | - Ana María Labraña
- Departamento de Nutrición y Dietética, Facultad de Farmacia, Universidad de Concepción, Concepción, Chile
| | - Karina Ramírez-Alarcón
- Departamento de Nutrición y Dietética, Facultad de Farmacia, Universidad de Concepción, Concepción, Chile
| | - Claudia Troncoso-Pantoja
- Departamento de Salud Pública, Facultad de Medicina, Centro de Investigación en Educación y Desarrollo (CIEDE-UCSC), Universidad Católica de la Santísima Concepción, Concepción, Chile
| | - Ana María Leiva
- Facultad de Medicina, Instituto de Anatomía, Histología y Patología, Universidad Austral, Valdivia, Chile
| | - Carlos Celis-Morales
- BHF Glasgow Cardiovascular Research Centre, School of Cardiovascular & Metabolic Health, University of Glasgow, Glasgow, United Kingdom
- Laboratorio de Rendimiento Humano, Grupo de Estudio en Educación, Actividad Física y Salud (GEEAFyS), Universidad Católica del Maule, Talca, Chile
| | - Fanny Petermann-Rocha
- Facultad de Medicina, Centro de Investigación Biomédica, Universidad Diego Portales, Santiago, Chile
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Ho FK, Zhou Z, Petermann-Rocha F, Para-Soto S, Boonpor J, Welsh P, Gill JMR, Gray SR, Sattar N, Pell JP, Celis-Morales C. Association Between Device-Measured Physical Activity and Incident Heart Failure: A Prospective Cohort Study of 94 739 UK Biobank Participants. Circulation 2022; 146:883-891. [PMID: 36036153 DOI: 10.1161/circulationaha.122.059663] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
BACKGROUND Studies of objectively measured physical activity (PA) have investigated acute cardiovascular outcomes but not heart failure (HF), an emerging chronic condition. This study aimed to investigate the dose-response relationship between device-measured PA and HF by intensity of PA. METHODS This was a prospective cohort study of 94 739 UK Biobank participants who had device-measured PA in 2013 to 2015 and were free from myocardial infarction and HF. PA was measured with a wrist-worn accelerometer, and time spent on light-, moderate-, and vigorous-intensity PA was extracted. Incident HF was ascertained from linked hospital and death records. Cox proportional hazard models with cubic penalized splines were used to study the associations, which were adjusted for sociodemographic and lifestyle factors. Competing risk was handled with cause-specific hazard ratios. RESULTS The overall incidence of HF was 98.5 per 10 000 person-years over a median 6.1 years of follow-up. Compared with participants who undertook no moderate- to vigorous-intensity PA, those who performed 150 to 300 min/wk of moderate-intensity PA (hazard ratio, 0.37 [95% CI, 0.34-0.41]) and 75 to 150 min/wk of vigorous-intensity PA (hazard ratio, 0.34 [95% CI, 0.25-0.46]) were at lower HF risk. The association between vigorous-intensity PA and HF was reverse-J shaped with a potentially lower risk reduction above 150 min/wk. CONCLUSIONS Device-measured PA, especially moderate-intensity PA, was associated with a lower risk of HF. Current vigorous-intensity PA recommendations should be encouraged but not increased. In contrast, increasing moderate-intensity PA may be beneficial even among those meeting current recommendations.
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Affiliation(s)
- Frederick K Ho
- Institute of Health and Wellbeing (F.K.H., Z.Z., F.P.-R., S.P.-S., J.P.P.), University of Glasgow, United Kingdom
| | - Ziyi Zhou
- Institute of Health and Wellbeing (F.K.H., Z.Z., F.P.-R., S.P.-S., J.P.P.), University of Glasgow, United Kingdom
| | - Fanny Petermann-Rocha
- Institute of Health and Wellbeing (F.K.H., Z.Z., F.P.-R., S.P.-S., J.P.P.), University of Glasgow, United Kingdom
- Institute of Cardiovascular & Medical Sciences (F.P.-R., S.P.-S., J.B., P.W., J.M.R.G., S.R.G., N.S., C.C.-M.), University of Glasgow, United Kingdom
- Facultad de Medicina, Universidad Diego Portales, Santiago, Chile (F.P.-R.)
| | - Solange Para-Soto
- Institute of Health and Wellbeing (F.K.H., Z.Z., F.P.-R., S.P.-S., J.P.P.), University of Glasgow, United Kingdom
- Institute of Cardiovascular & Medical Sciences (F.P.-R., S.P.-S., J.B., P.W., J.M.R.G., S.R.G., N.S., C.C.-M.), University of Glasgow, United Kingdom
| | - Jirapitcha Boonpor
- Institute of Cardiovascular & Medical Sciences (F.P.-R., S.P.-S., J.B., P.W., J.M.R.G., S.R.G., N.S., C.C.-M.), University of Glasgow, United Kingdom
| | - Paul Welsh
- Institute of Cardiovascular & Medical Sciences (F.P.-R., S.P.-S., J.B., P.W., J.M.R.G., S.R.G., N.S., C.C.-M.), University of Glasgow, United Kingdom
| | - Jason M R Gill
- Institute of Cardiovascular & Medical Sciences (F.P.-R., S.P.-S., J.B., P.W., J.M.R.G., S.R.G., N.S., C.C.-M.), University of Glasgow, United Kingdom
| | - Stuart R Gray
- Institute of Cardiovascular & Medical Sciences (F.P.-R., S.P.-S., J.B., P.W., J.M.R.G., S.R.G., N.S., C.C.-M.), University of Glasgow, United Kingdom
| | - Naveed Sattar
- Institute of Cardiovascular & Medical Sciences (F.P.-R., S.P.-S., J.B., P.W., J.M.R.G., S.R.G., N.S., C.C.-M.), University of Glasgow, United Kingdom
| | - Jill P Pell
- Institute of Health and Wellbeing (F.K.H., Z.Z., F.P.-R., S.P.-S., J.P.P.), University of Glasgow, United Kingdom
| | - Carlos Celis-Morales
- Institute of Cardiovascular & Medical Sciences (F.P.-R., S.P.-S., J.B., P.W., J.M.R.G., S.R.G., N.S., C.C.-M.), University of Glasgow, United Kingdom
- Human Performance Lab, Education, Physical Activity and Health Research Unit, University Católica del Maule, Talca, Chile (C.C.-M.)
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Ho FK, Petermann-Rocha F, Parra-Soto S, Boonpor J, Gill JMR, Gray SR, Pell JP, Celis-Morales C. Device-measured physical activity and incident affective disorders. BMC Med 2022; 20:290. [PMID: 36064521 PMCID: PMC9446787 DOI: 10.1186/s12916-022-02484-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 07/14/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Studies on physical activity (PA) and mental health are largely limited to self-reported PA. This study aims to use prospective cohort data to investigate the association between device-measured PA and affective disorders. METHODS A total of 37,327 participants from UK Biobank who had not had any prior affective disorder diagnoses were included in this prospective cohort study. Wrist-worn accelerometers were used to measure total, light (LPA), moderate (MPA), and vigorous (VPA) PA. Associations between PA domains and affective disorders were analysed using penalised splines in Cox proportional hazard models. Analyses were adjusted for other intensity-specific PA and sociodemographic and lifestyle factors. Sensitivity analyses were conducted adjusting for body mass index and longstanding illnesses as well as excluding events in the first 2 years of follow-up. Preventable fractions for the population were estimated for MPA and VPA. RESULTS Over a median follow-up of 6.8 years, 1262 (3.4%) individuals were diagnosed with affective disorders. Replacing 30 min of sedentary behaviour in a week with MPA (HR 0.95, 95% CI 0.94-0.97) or VPA (HR 0.91, 95% CI 0.85-0.98) was associated with lower risk of affective behaviours, up to 500 and 120 min of MPA and VPA. Assuming causality, 5.14% and 18.88% of affective disorders could have been prevented if MPA ≥150 min/week and VPA ≥75 min/week were achieved, respectively, across the study population. CONCLUSIONS Device-measured MPA and VPA were associated with lower risk of affective disorders. The potential mental health benefits of MPA continue to accrue above the current World Health Organization recommendation.
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Affiliation(s)
- Frederick K Ho
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Fanny Petermann-Rocha
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK.,Institute of Cardiovascular & Medical Sciences, University of Glasgow, Glasgow, G12 8TA, UK.,Facultad de Medicina, Universidad Diego Portales, Santiago, Chile
| | - Solange Parra-Soto
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK.,Institute of Cardiovascular & Medical Sciences, University of Glasgow, Glasgow, G12 8TA, UK
| | - Jirapitcha Boonpor
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK.,Institute of Cardiovascular & Medical Sciences, University of Glasgow, Glasgow, G12 8TA, UK
| | - Jason M R Gill
- Institute of Cardiovascular & Medical Sciences, University of Glasgow, Glasgow, G12 8TA, UK
| | - Stuart R Gray
- Institute of Cardiovascular & Medical Sciences, University of Glasgow, Glasgow, G12 8TA, UK
| | - Jill P Pell
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Carlos Celis-Morales
- Institute of Cardiovascular & Medical Sciences, University of Glasgow, Glasgow, G12 8TA, UK. .,Human Performance Lab, Education, Physical Activity and Health Research Unit, University Católica del Maule, 3466706, Talca, Chile.
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Boonpor J, Parra-Soto S, Petermann-Rocha F, Ho FK, Celis-Morales C, Gray SR. Combined association of walking pace and grip strength with incident type 2 diabetes. Scand J Med Sci Sports 2022; 32:1356-1365. [PMID: 35612725 PMCID: PMC9544034 DOI: 10.1111/sms.14197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 05/04/2022] [Accepted: 05/09/2022] [Indexed: 11/28/2022]
Abstract
The current study aims to investigate the combined association of walking pace and grip strength with incident type 2 diabetes (T2D). A total of 205 738 participants (mean age 56.6 ± 8.1 years, 115 139 [56.0%] women) without diagnosed or unknown diabetes at baseline from the UK Biobank study were included in this prospective study. Walking pace was self-reported as slow, average, or brisk. Grip strength was measured using a dynamometer and classified as weak, average, and strong. The combined association of walking pace and grip strength with incident T2D was investigated using Cox-proportional hazards models with a 2-year landmark analysis. The additive interaction was conducted by estimating relative excess risk due to interaction (RERI). After the median follow-up period of 5.4 years (interquartile range: 4.8-6.5), 5082 (2.5%) participants were diagnosed with T2D. Compared to brisk-strong individuals (reference group), people who were slow-weak had a higher risk of T2D (hazard ratio: 1.64 [95% CI, 1.42-1.89]) after adjusting for all covariates. There were dose-response gradients across both walking pace and grip strength variables. There was a modest amount of negative additive interaction (RERI; -0.06 [95% CI, -0.16; -0.01]. To conclude, slower pace and weaker grip strength were associated with a higher risk of developing T2D, independent of sociodemographics, lifestyle, and adiposity. Combining walking pace and grip strength might be a practical approach to screening people who are at increased risk of developing T2D.
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Affiliation(s)
- Jirapitcha Boonpor
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.,Faculty of Public Health, Chalermphrakiat Sakon Nakhon Province Campus, Kasetsart University, Sakon Nakhon, Thailand
| | - Solange Parra-Soto
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.,Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Fanny Petermann-Rocha
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.,Facultad de Medicina, Universidad Diego Portales, Santiago, Chile
| | - Frederick K Ho
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Carlos Celis-Morales
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.,Human Performance Lab, Education, Physical Activity and Health Research Unit, University Católica del Maule, Talca, Chile
| | - Stuart R Gray
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
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Vásquez-Gómez J, Álvarez C, Concha-Cisternas Y, Beltrán AR, Díaz-Martínez X, Cigarroa I, Parra-Soto S, Petermann-Rocha F, Celis-Morales C. [Association of cardiorespiratory fitness with adiposity markers]. Rev Med Chil 2022; 150:1152-1161. [PMID: 37358125 DOI: 10.4067/s0034-98872022000901152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 04/26/2022] [Indexed: 06/27/2023]
Abstract
BACKGROUND Cardiorespiratory fitness (CRF) is inversely associated with metabolic diseases and adiposity markers. AIM To assess the association of CRF with body mass index (BMI), waist circumference (WC) and obesity in a representative sample of the Chilean population. MATERIAL AND METHODS Data from 5,958 participants in the Chilean National Health Survey 2016-1027 aged 15 years or above were analyzed. CRF was estimated by an equation that included sociodemographic, anthropometric and health-related data and expressed in metabolic equivalent units (METs). The association between CRF and adiposity was assessed using linear and Poisson regression models and the results were presented as Prevalence Ratio (PR). RESULTS One MET increment in CRF was associated with a 3.27 kg/m2 (95% confidence intervals (CI): -3.35; -3.2) and 4.56 kg/m2 (95% CI: -4.67; -4.46) lower BMI in men and women, respectively. Waist circumference was 6.7 cm [95% CI: -6.98; -6.42] and 9 cm [95% CI: -9.33; -8.67] lower per 1-MET increment in CRF. With one MET increment, the probability of being obese was 34% (PR = 0.66 [95%CI: 0.63; 0.69]) and 36% (PR = 0.64 [95%CI: 0.61; 0.67]) lower in men and women, respectively. The probability of having a central obesity was 26% (PR = 0.74 [95%CI: 0.71; 0.77]) and 30% (PR = 0.70 [95%CI: 0.68; 0.73]) lower in men and women, respectively. CONCLUSIONS A higher estimated CRF was associated with lower adiposity levels and a lower risk of being obese in both men and women. Public health policies aiming to increase physical activity are needed to increase the CRF of the Chilean population.
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Affiliation(s)
- Jaime Vásquez-Gómez
- Centro de Investigación de Estudios Avanzados del Maule, Universidad Católica del Maule, Talca, Chile
| | - Cristian Álvarez
- School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago, Chile
| | | | - Ana Rosa Beltrán
- Departamento de Educación, Facultad de Educación, Universidad de Antofagasta, Antofagasta, Chile
| | | | - Igor Cigarroa
- Escuela de Kinesiología, Facultad de Salud, Universidad Santo Tomas, Chile
| | - Solange Parra-Soto
- Departamento de Nutrición y Salud Pública, Facultad Ciencias de la Salud y de los Alimentos, Universidad del Bío-Bío, Chillán, Chile
| | - Fanny Petermann-Rocha
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom
| | - Carlos Celis-Morales
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom
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Livingstone KM, Brayner B, Celis-Morales C, Moschonis G, Manios Y, Traczyk I, Drevon CA, Daniel H, Saris WHM, Lovegrove JA, Gibney M, Gibney ER, Brennan L, Martinez JA, Mathers JC. Associations between dietary patterns, FTO genotype and obesity in adults from seven European countries. Eur J Nutr 2022; 61:2953-2965. [PMID: 35307761 PMCID: PMC9363276 DOI: 10.1007/s00394-022-02858-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 03/02/2022] [Indexed: 11/23/2022]
Abstract
PURPOSE High-fat and low-fibre discretionary food intake and FTO genotype are each associated independently with higher risk of obesity. However, few studies have investigated links between obesity and dietary patterns based on discretionary food intake, and the interaction effect of FTO genotype are unknown. Thus, this study aimed to derive dietary patterns based on intake of discretionary foods, saturated fatty acids (SFA) and fibre, and examine cross-sectional associations with BMI and waist circumference (WC), and interaction effects of FTO genotype. METHODS Baseline data on 1280 adults from seven European countries were included (the Food4Me study). Dietary intake was estimated from a Food Frequency Questionnaire. Reduced rank regression was used to derive three dietary patterns using response variables of discretionary foods, SFA and fibre density. DNA was extracted from buccal swabs. Anthropometrics were self-measured. Linear regression analyses were used to examine associations between dietary patterns and BMI and WC, with an interaction for FTO genotype. RESULTS Dietary pattern 1 (positively correlated with discretionary foods and SFA, and inversely correlated with fibre) was associated with higher BMI (β:0.64; 95% CI 0.44, 0.84) and WC (β:1.58; 95% CI 1.08, 2.07). There was limited evidence dietary pattern 2 (positively correlated with discretionary foods and SFA) and dietary pattern 3 (positively correlated with SFA and fibre) were associated with anthropometrics. FTO risk genotype was associated with higher BMI and WC, with no evidence of a dietary interaction. CONCLUSIONS Consuming a dietary pattern low in discretionary foods and high-SFA and low-fibre foods is likely to be important for maintaining a healthy weight, regardless of FTO predisposition to obesity. TRIAL REGISTRATION Clinicaltrials.gov NCT01530139. Registered 9 February 2012 https://clinicaltrials.gov/ct2/show/NCT01530139.
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Affiliation(s)
- Katherine M Livingstone
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, 1 Gheringhap St, Geelong, 3220, Australia.
| | - Barbara Brayner
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, 1 Gheringhap St, Geelong, 3220, Australia
| | - Carlos Celis-Morales
- BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, 126 University Pl, Glasgow, G12 8TA, UK
- Human Performance Lab, Education, Physical Activity and Health Research Unit, University Católica del Maule, 3466706, Talca, Chile
| | - George Moschonis
- Department of Dietetics, Nutrition and Sport, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC, 3086, Australia
| | - Yannis Manios
- Department of Dietetics, Nutrition and Sport, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC, 3086, Australia
| | - Iwona Traczyk
- Department of Human Nutrition, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland
| | - Christian A Drevon
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Hannelore Daniel
- Molecular Nutrition Unit, Department Food and Nutrition, Technische Universität München, München, Germany
| | - Wim H M Saris
- Department of Human Biology, NUTRIM, School for Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Julie A Lovegrove
- Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, Department of Food and Nutritional Sciences, University of Reading, Reading, UK
| | - Mike Gibney
- UCD Institute of Food and Health, UCD School of Agriculture and Food Science, University College Dublin, Belfield, Dublin 4, Republic of Ireland
| | - Eileen R Gibney
- UCD Institute of Food and Health, UCD School of Agriculture and Food Science, University College Dublin, Belfield, Dublin 4, Republic of Ireland
| | - Lorraine Brennan
- UCD Institute of Food and Health, UCD School of Agriculture and Food Science, University College Dublin, Belfield, Dublin 4, Republic of Ireland
| | - J Alfredo Martinez
- Precision Nutrition and Cardiometabolic Health, IMDEA-Food Institute (Madrid Institute for Advanced Studies), CEI UAM + CSIC, Madrid, Spain
| | - John C Mathers
- Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
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Cabanas-Sánchez V, Esteban-Cornejo I, Parra-Soto S, Petermann-Rocha F, Gray SR, Rodríguez-Artalejo F, Ho FK, Pell JP, Martínez-Gómez D, Celis-Morales C. Muscle strength and incidence of depression and anxiety: findings from the UK Biobank prospective cohort study. J Cachexia Sarcopenia Muscle 2022; 13:1983-1994. [PMID: 35678014 PMCID: PMC9398224 DOI: 10.1002/jcsm.12963] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 02/02/2022] [Accepted: 02/03/2022] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Depression and anxiety are the leading mental health problems worldwide; depression is ranked as the leading cause of global disability with anxiety disorders ranked sixth. Preventive strategies based on the identification of modifiable factors merit exploration. The aim of the present study was to investigate the associations of handgrip strength (HGS) with incident depression and anxiety and to explore how these associations differ by socio-demographic, lifestyle, and health-related factors. METHODS The analytic sample comprised 162 167 participants (55% women), aged 38-70 years, from the UK Biobank prospective cohort study. HGS was assessed at baseline using dynamometry. Depression and anxiety were extracted from primary care and hospital admission records. Cox proportional models were applied, with a 2 year landmark analysis, to investigate the associations between HGS and incident depression and anxiety. RESULTS Of the 162 167 participants included, 5462 (3.4%) developed depression and 6614 (4.1%) anxiety, over a median follow-up period of 10.0 years (inter-quartile range: 9.3-10.8) for depression and 9.9 (inter-quartile range: 9.0-10.8) for anxiety. In the fully adjusted model, a 5 kg lower HGS was associated with a 7% (HR: 1.07 [95% CI: 1.05, 1.10]; P < 0.001) and 8% (HR: 1.08 [95% CI: 1.06, 1.10]; P < 0.001) higher risk of depression and anxiety, respectively. Compared with participants in the sex and age-specific highest tertiles of HGS, those in the medium and lowest tertiles had an 11% (HR: 1.11 [95% CI: 1.04, 1.19]; P = 0.002) and 24% (HR: 1.24 [95% CI: 1.16, 1.33]; P < 0.001) higher risk of depression and 13% (HR: 1.13 [95% CI: 1.06, 1.20]; P < 0.001) and 27% (HR: 1.27 [95% CI: 1.19, 1.35]; P < 0.001) higher risk of anxiety, respectively. The association of HGS with depression was stronger among participants with average or brisk walking pace (vs. slow walking pace; Pinteraction < 0.001). The association with anxiety was stronger in those participants aged ≥58 years (vs. ≤58 years; Pinteraction = 0.002) and those living in more affluent areas (vs. deprived; Pinteraction = 0.001). CONCLUSIONS Handgrip strength was inversely associated with incident depression and anxiety. Because HGS is a simple, non-invasive, and inexpensive measure, it could be easily used in clinical practice to stratify patients and identify those at elevated risk of mental health problems. However, future research should assess if resistance training aimed at increasing HGS can prevent the occurrence of mental health conditions.
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Affiliation(s)
- Verónica Cabanas-Sánchez
- IMDEA Food Institute, CEI UAM+CSIC, Madrid, Spain.,Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Irene Esteban-Cornejo
- PROFITH 'PROmoting FITness and Health through physical activity' Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Solange Parra-Soto
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.,Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Fanny Petermann-Rocha
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.,Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK.,Facultad de Medicina, Universidad Diego Portales, Santiago, Chile
| | - Stuart R Gray
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Fernando Rodríguez-Artalejo
- IMDEA Food Institute, CEI UAM+CSIC, Madrid, Spain.,Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Cardiovascular and Nutritional Epidemiology Group, IdiPAZ (La Paz University Hospital-Universidad Autónoma de Madrid), Madrid, Spain
| | - Frederick K Ho
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Jill P Pell
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - David Martínez-Gómez
- IMDEA Food Institute, CEI UAM+CSIC, Madrid, Spain.,Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Carlos Celis-Morales
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.,Laboratorio de Rendimiento Humano, Grupo de Estudio en Educación, Actividad Física y Salud (GEEAFyS), Universidad Católica del Maule, Talca, Chile
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