1
|
Chen Z, Xu J, Ye P, Xin X. Nonlinearity association of serum calcium with the risk of anaemia in US adults. Hematology 2023; 28:2217598. [PMID: 37249421 DOI: 10.1080/16078454.2023.2217598] [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] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
BACKGROUND Calcium plays a key role in many bio-homeostasis functions. Previous studies indicated that serum calcium is associated with diseases such as anaemia. However, the evidence on the association between serum calcium levels and anaemia risk is limited. Thus, the purpose of our study is to investigate the relationship between serum calcium and anaemia in US adults. METHODS This cross-sectional study used data from the National Health and Nutrition Examination Survey (NHANES) including 15,519 participants, aged ≥18 years. The analyses were performed using multivariate logistic regression and a generalized additive model (GAM). Subgroup analysis, stratified by gender and age, was also performed. RESULTS Among the sample of 15,519 individuals, 1565 (10.8%) had been diagnosed with anaemia. Both the univariate logistic regression model and multivariate logistic regression model showed a reverse relationship between serum calcium and anaemia risk. Moreover, a non-linear association between serum calcium and anaemia risk was observed using GAM and smooth curve fitting. The inflection point of serum calcium was at 2.3 mmol/L. GAM with penalized splines suggested a reverse association between serum calcium and the prevalence of anaemia when the concentration of serum calcium was below 2.3 mmol/L. In contrast, we found no statistically significant difference when serum calcium concentration was higher than the inflection point (2.3 mmol/L). CONCLUSION Lower serum calcium levels were associated with increased risk of anaemia risk. Moreover, we observed non-linear associations between serum calcium and anaemia risk. Our results need to be confirmed in future prospective studies.
Collapse
Affiliation(s)
- Zeling Chen
- Department of Breast, Ganzhou Maternal and Child Health Hospital, Ganzhou, People's Republic of China
| | - Jing Xu
- Department of Clinical Laboratory, Ganzhou People's Hospital, Ganzhou, People's Republic of China
| | - Ping Ye
- Department of Clinical Laboratory, Ganzhou People's Hospital, Ganzhou, People's Republic of China
| | - Xiaoqin Xin
- Department of Clinical Laboratory, Ganzhou People's Hospital, Ganzhou, People's Republic of China
| |
Collapse
|
2
|
Rahman HH, Toohey W, Munson-McGee SH. Exposure to arsenic, polycyclic aromatic hydrocarbons, metals, and association with skin cancers in the US adults. Environ Sci Pollut Res Int 2023; 30:101681-101708. [PMID: 37653200 DOI: 10.1007/s11356-023-29422-8] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 08/17/2023] [Indexed: 09/02/2023]
Abstract
Worldwide, skin cancer affects millions of people yearly and is broadly classified into melanoma and nonmelanoma types of skin cancer. The toxicity of metals to human health is a public and clinical health problem due to their widespread use in tools, machinery, and appliances as well as their widespread distribution in the air, water, and soil. Arsenic is a carcinogenic metalloid and available in the Earth's crust. Polycyclic aromatic hydrocarbons (PAHs) are toxic to humans, and incomplete combustion of fossil fuels is the main source of PAHs. Human populations exposed to metals from various sources can lead to various diseases including cancer. Limited studies are conducted to simultaneously assess the correlation of multiple arsenic, PAHs, metals with the occurrence of skin cancer. This study aimed to analyze the association between six PAHs compounds, seven types of arsenic, and fourteen metals from urine specimen with skin cancer in US adults. We performed a cross-sectional analysis using data from a total of 14,716 adults from the National Health Examination and Nutrition Survey (NHANES) database for three cycles ranging from 2011-2012 to 2015-2016. Specialized weighted complex survey logit regressions were conducted. Linear logit regression models using only main effects were performed first to identify the correlation between the selected demographic and lifestyle variables and melanoma, nonmelanoma, and unknown types of skin cancer. A second set of linear, main-effects logit regression models were constructed to examine the correlation between melanoma, nonmelanoma, and other types of skin cancers and seven types of arsenic (arsenous acid, arsenic acid, arsenobetaine, arsenocholine, dimethylarsinic acid, monomethylacrsonic acid, and total arsenic), six PAHs (1-hydroxynaphthalene, 2-hydroxynaphthalene, 3-hydroxyfluorene, 2-hydroxyfluorene, 1-hydroxyphenathrene, and 1-hydroxypyrene), and fourteen metals (barium, cadmium, cobalt, cesium, molybdenum, manganese, lead, antimony, tin, strontium, thallium, tungsten, uranium, and mercury) when adjusted for the selected covariates. The statistical analysis was conducted using R software, version 4.0.4. A marginal positive significant correlation between total arsenic and nonmelanoma was observed. This study identified a significant positive association between barium, cadmium, cesium, mercury, tin, and melanoma development. Cesium showed a significant positive statistical association for nonmelanoma, and thallium showed a borderline significant statistical association for nonmelanoma. A statistically significant positive association was found between cadmium and an unknown type of skin cancer. The findings of this study indicated a statistically significant positive association between skin cancer and barium, cadmium, cesium, tin, mercury, and thallium. Further studies are recommended in humans to refute or confirm these findings.
Collapse
Affiliation(s)
| | - Walker Toohey
- Burrell College of Osteopathic Medicine, 3501 Arrowhead Dr, Las Cruces, NM, 88003, USA
| | | |
Collapse
|
3
|
Zhang S, Tang H, Zhou M. Sex-specific associations between nine metal mixtures in urine and urine flow rate in US adults: NHANES 2009-2018. Front Public Health 2023; 11:1241971. [PMID: 37575093 PMCID: PMC10420057 DOI: 10.3389/fpubh.2023.1241971] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 07/19/2023] [Indexed: 08/15/2023] Open
Abstract
Background The urinary system serves as a crucial pathway for eliminating metallic substances from the body, making it susceptible to the effects of metal exposure. However, limited research has explored the association between metal mixtures and bladder function. This study aims to investigate the relationship between urinary metal mixtures (specifically barium, cadmium, cobalt, cesium, molybdenum, lead, antimony, thallium, and tungsten) and urine flow rate (UFR) in the general population, utilizing multiple mixture analysis models. Methods This study utilizes data obtained from the National Health and Nutrition Examination Survey. After adjusting for relevant covariates, we assessed the correlations between metal mixtures and UFR using three distinct analysis models: weighted quantile sum (WQS), quantile g-computation (qgcomp), and Bayesian kernel machine regression (BKMR). Additionally, a gender-stratified analysis was conducted. Finally, we also performed sensitivity analyses. Results A total of 7,733 subjects were included in this study, with 49% being male. The WQS regression model, when fitted in the positive direction, did not yield any significant correlations in the overall population or in the male and female subgroups. However, when analyzed in the negative direction, the WQS index exhibited a negative correlation with UFR in the overall group (β = -0.078; 95% CI: -0.111, -0.045). Additionally, a significant negative correlation between the WQS index and UFR was observed in the female group (β = -0.108; 95% CI: -0.158, -0.059), while no significant correlation was found in the male group. The results obtained from the qgcomp regression model were consistent with those of the WQS regression model. Similarly, the BKMR regression model revealed a significant negative correlation trend between metal mixtures and UFR, with cadmium and antimony potentially playing key roles. Conclusion Our study revealed a significant negative correlation between urinary metal mixture exposure and mean UFR in US adults, with notable gender differences. Specifically, higher urinary levels of cadmium and antimony were identified as potential key factors contributing to the decrease in mean UFR. These findings significantly contribute to the existing knowledge on the impact of metal mixtures on bladder function and provide valuable insights for safeguarding bladder health and preventing impaired bladder function.
Collapse
Affiliation(s)
- Shuai Zhang
- Department of Male Reproductive Health, Lianyungang Maternal and Child Health Hospital, Lianyungang, China
- Clinical Center of Reproductive Medicine, Lianyungang Maternal and Child Health Hospital, Lianyungang, China
| | - Hanhan Tang
- Graduate School of Xuzhou Medical University, Xuzhou Medical University, Xuzhou, China
| | - Minglian Zhou
- Department of Male Reproductive Health, Lianyungang Maternal and Child Health Hospital, Lianyungang, China
- Clinical Center of Reproductive Medicine, Lianyungang Maternal and Child Health Hospital, Lianyungang, China
| |
Collapse
|
4
|
Lv JJ, Li XY, Shen YC, You JX, Wen MZ, Wang JB, Yang XT. Assessing volatile organic compounds exposure and chronic obstructive pulmonary diseases in US adults. Front Public Health 2023; 11:1210136. [PMID: 37475768 PMCID: PMC10354632 DOI: 10.3389/fpubh.2023.1210136] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 06/13/2023] [Indexed: 07/22/2023] Open
Abstract
Background Volatile organic compounds (VOCs) are a large group of chemicals widely used in People's Daily life. There is increasing evidence of the cumulative toxicity of VOCs. However, the association between VOCs and the risk of COPD has not been reported. Objective We comprehensively evaluated the association between VOCs and COPD. Methods Our study included a total of 1,477 subjects from the National Health and Nutrition Examination Survey, including VOCs, COPD, and other variables in the average US population. Multiple regression models and smooth-curve fitting (penalty splines) were constructed to examine potential associations, and stratified analyses were used to identify high-risk groups. Results We found a positive association between blood benzene and blood o-xylene concentrations and COPD risk and identified a concentration relationship between the two. That is, when the blood benzene and O-xylene concentrations reached 0.28 ng/mL and 0.08 ng/mL, respectively, the risk of COPD was the highest. In addition, we found that gender, age, and MET influence the relationship, especially in women, young people, and people with low MET. Significance This study revealed that blood benzene and blood o-xylene were independently and positively correlated with COPD risk, suggesting that long-term exposure to benzene and O-xylene may cause pulmonary diseases, and providing a new standard of related blood VOCs concentration for the prevention of COPD.
Collapse
Affiliation(s)
- Jia-jie Lv
- Department of Interventional Therapy, Multidisciplinary Team of Vascular Anomalies, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University, Shanghai, China
- Department of Vascular Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Xin-yu Li
- Department of Interventional Therapy, Multidisciplinary Team of Vascular Anomalies, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University, Shanghai, China
- Department of Neurosurgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Yu-chen Shen
- Department of Interventional Therapy, Multidisciplinary Team of Vascular Anomalies, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Jian-xiong You
- Department of Interventional Therapy, Multidisciplinary Team of Vascular Anomalies, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Ming-zhe Wen
- Department of Interventional Therapy, Multidisciplinary Team of Vascular Anomalies, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Jing-bing Wang
- Department of Interventional Therapy, Multidisciplinary Team of Vascular Anomalies, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Xi-tao Yang
- Department of Interventional Therapy, Multidisciplinary Team of Vascular Anomalies, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University, Shanghai, China
| |
Collapse
|
5
|
Wang Y, Ming J, Guo Z, Zhang W, Li X, Zhou S, Li X, Ma H. Association of serum uric acid with anemia in U.S. adults: a cross-sectional study using secondary data. BMC Cardiovasc Disord 2023; 23:291. [PMID: 37291524 PMCID: PMC10251553 DOI: 10.1186/s12872-023-03291-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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 05/10/2023] [Indexed: 06/10/2023] Open
Abstract
BACKGROUND High serum uric acid (SUA) is a risk factor of cardiovascular disease (CVD). Abnormal SUA have been correlated with a significant increase in mortality. Anemia is an independent predictor of mortality and CVD. To date, no study has investigated the relationship between SUA and anemia. Here, we explored the correlation between SUA and anemia in the American population. METHODS The cross-sectional study involved 9205 US adults from NHANES (2011-2014). The relationship between SUA and anemia was explored using multivariate linear regression models. Two-piecewise linear regression model, generalized additive models (GAM) and smooth curve fitting were performed to explore the non-linear relationships between SUA and anemia. RESULTS We found a U-shaped non-linear relationship between SUA and anemia. The inflection point of the SUA concentration curve was 6.2 mg/dL. The ORs (95% CIs) for anemia on the left and right of the inflection point were 0.86 (0.78-0.95) and 1.33 (1.16-1.52), respectively. The 95% CI of inflection point was 5.9-6.5 mg/dL. The findings showed that both genders presented a U-shaped correlation. Safe ranges of SUA in men and women were 6-6.5 and 4.3-4.6 mg/dL, respectively. CONCLUSIONS Both high and low SUA levels were correlated with increased risk of anemia, and a U-shaped relationship was observed between SUA and anemia.
Collapse
Affiliation(s)
- Yingying Wang
- Department of Nephrology, Jining No.1 People's Hospital, Jining, Shandong, China
| | - Jingjing Ming
- Department of Emergency Trauma Surgery, Jining No.1 People's Hospital, Jining, Shandong, China
| | - Zongyun Guo
- Department of Nephrology, Jining No.1 People's Hospital, Jining, Shandong, China
| | - Wei Zhang
- Department of Nephrology, Jining No.1 People's Hospital, Jining, Shandong, China
| | - Xiang Li
- Department of Nephrology, Affiliated Hospital of Jining Medical University, No.6 Jiankang Road, Jining, 272011, Shandong, China
| | - Shengguo Zhou
- Department of Nephrology, Jining No.1 People's Hospital, Jining, Shandong, China
| | - Xia Li
- Department of Nephrology, Jining No.1 People's Hospital, Jining, Shandong, China.
| | - Huijuan Ma
- Department of Nephrology, Jining No.1 People's Hospital, Jining, Shandong, China.
| |
Collapse
|
6
|
Reece S, CarlLee S, Scott AJ, Willis DE, Rowland B, Larsen K, Holman-Allgood I, McElfish PA. Hesitant adopters: COVID-19 vaccine hesitancy among diverse vaccinated adults in the United States. Infect Med (Beijing) 2023; 2:89-95. [PMID: 38013742 PMCID: PMC10038887 DOI: 10.1016/j.imj.2023.03.001] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 03/03/2023] [Accepted: 03/19/2023] [Indexed: 07/11/2023]
Abstract
Background Despite the United States (US) having an abundant supply of COVID-19 vaccines, vaccination rates lag behind other high-income countries, suggesting that vaccine hesitancy and attitudes play a greater role in public health measures than pure supply and access. With the acknowledgment that vaccination attitudes and status may or may not be correlated, this study examined COVID-19 vaccine hesitancy among vaccinated US adults by asking: 1) What is the prevalence of COVID-19 vaccine hesitancy among the vaccinated? 2) Does COVID-19 vaccine hesitancy vary across sociodemographic characteristics? 3) Does COVID-19 vaccine hesitancy vary by healthcare access and influenza vaccination over the past 5 years? Methods Data were collected through an online survey of 2022 US adults with a final analytic sample of 1383 vaccinated respondents. Results Overall, 48.8% of vaccinated adults reported some level of hesitancy, while a slight majority reported they were "not at all hesitant". Younger respondents, women, and Black and American Indian or Alaska Native participants had greater adjusted odds of being more hesitant towards receiving the COVID-19 vaccine. Respondents who had a primary care physician had greater adjusted odds than those who did not have a primary care physician of being more hesitant towards receiving the COVID-19 vaccine. Conclusions This is the first population-based national sample study examining COVID-19 vaccine hesitancy among vaccinated individuals from subgroups of distinctive backgrounds in order to inform targeted strategies for reducing vaccine hesitancy. Findings can assist in efforts to increase vaccination rates and also decrease vaccine hesitancy at the national level.
Collapse
Affiliation(s)
- Sharon Reece
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR 72703, USA
| | - Sheena CarlLee
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR 72703, USA
| | - Aaron J Scott
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, Springdale, AR 72703, USA
| | - Don E Willis
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Springdale, AR 72703, USA
| | - Brett Rowland
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, Springdale, AR 72703, USA
| | - Kristin Larsen
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR 72703, USA
| | - Ijanae Holman-Allgood
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR 72703, USA
| | - Pearl A McElfish
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Springdale, AR 72703, USA
| |
Collapse
|
7
|
Park S, Lee SH, Blanck HM. Characteristics Associated with Being a High Consumer of Sweet Foods and Sugar-Sweetened Beverages among US Adults during the COVID-19 Pandemic, 2021. Nutrients 2023; 15:nu15102363. [PMID: 37242246 DOI: 10.3390/nu15102363] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 05/08/2023] [Accepted: 05/16/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic impacted some dietary habits of Americans. OBJECTIVE We examined characteristics associated with a high intake of sweet foods and sugar-sweetened beverages (SSB) during the COVID-19 pandemic among US adults. DESIGN This was a cross-sectional study. PARTICIPANTS/SETTINGS The SummerStyles survey data were collected in 2021 among 4034 US adults (≥18 years). MAIN OUTCOME MEASURES The frequencies were measured of consuming various sweet foods (chocolate/candy, doughnuts/sweet rolls/Danish/muffins/Pop-Tarts, cookies/cake/pie/brownies, and ice cream/frozen desserts) and SSB (regular sodas, sweetened coffee/tea drinks fruit drinks, sports drinks, and energy drinks) during the COVID-19 pandemic. The responses were categorized into 0, >0 to <1, 1 to <2, and ≥2 times/day. The descriptive variables were sociodemographics, food insecurity, weight status, metropolitan status, census regions, and eating habit changes during the COVID-19 pandemic. STATISTICAL ANALYSES PERFORMED Multinomial regressions were used to estimate adjusted odds ratios (AOR) for being a high consumer of sweet foods and SSB after controlling for characteristics. RESULTS During 2021, 15% of adults reported consuming sweet foods ≥2 times/day, and 30% reported drinking SSB ≥2 times/day. The factors that were significantly associated with greater odds of high sweet food intake (≥2 times/day) were lower household income (AOR = 1.53 for <$35,000 vs. ≥$100,000), often/sometimes experiencing food insecurity (AOR = 1.41 vs. never), and eating more sweet foods than usual since start of the pandemic (AOR = 2.47 vs. same as usual). The factors that were significantly associated with greater odds of high SSB intake (≥2 times/day) were males (AOR = 1.51), lower education (AOR = 1.98 for ≤high school; AOR = 1.33 for some college vs. college graduate), currently having children (AOR = 1.65), living in nonmetropolitan areas (AOR = 1.34), and drinking more SSB than usual since the pandemic began (AOR = 2.23 vs. same as usual). Younger age, Black race, and reductions in consumption during COVID-19 were related to lower sweet food and SSB intakes. CONCLUSIONS Our findings, which identified high consumers of sweet foods or SSB, can be used to inform efforts to reduce consumers' added sugars intake during pandemic recovery and support their health.
Collapse
Affiliation(s)
- Sohyun Park
- Division of Nutrition, Physical Activity, and Obesity (DNPAO), National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Centers for Disease Control and Prevention (CDC), 4770 Buford Highway, NE, Atlanta, GA 30341, USA
- Division of Overdose Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway, NE, Atlanta, GA 30341, USA
| | - Seung Hee Lee
- Division of Nutrition, Physical Activity, and Obesity (DNPAO), National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Centers for Disease Control and Prevention (CDC), 4770 Buford Highway, NE, Atlanta, GA 30341, USA
| | - Heidi M Blanck
- Division of Nutrition, Physical Activity, and Obesity (DNPAO), National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Centers for Disease Control and Prevention (CDC), 4770 Buford Highway, NE, Atlanta, GA 30341, USA
| |
Collapse
|
8
|
Nguyen N, Keyhani S, Ling PM, Hoggatt KJ, Hasin D, Cohen BE. Self-reported Changes in Cannabis Use Due to the COVID-19 Pandemic among US Adults. J Psychoactive Drugs 2022; 54:295-299. [PMID: 35356866 PMCID: PMC9522913 DOI: 10.1080/02791072.2022.2058897] [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: 01/11/2022] [Revised: 03/01/2022] [Accepted: 03/15/2022] [Indexed: 10/18/2022]
Abstract
Cannabis use may confer high COVID-19 risk. This study examined self-reported changes in cannabis use that US adults attributed to the pandemic and factors associated with any changes. We conducted a national, cross-sectional survey among US adults in August 2020. The analytic sample included 957 past-year cannabis users (Mage = 43 years old; 51% male). Weighted multinomial regression examined associations between forms and reasons of cannabis used, perceived addictiveness and safety, co-use of cannabis with tobacco/alcohol, state legalization, and the outcome (self-reported increase/decrease in cannabis use vs. no change). Overall, 14.8% reported decreasing cannabis use due to the pandemic, 16.1% reported increasing, and 65.4% reported not changing. Factors associated with increased cannabis use included past-year use of vaporized (AOR = 1.7, 95% CI = 1.0, 3.0) or edible cannabis (AOR = 2.4, CI = 1.3, 4.3), and simultaneous use of cannabis and tobacco (AOR = 2.6; CI = 1.4, 5.2). Young adults (18-29 years old) had higher odds of self-reporting both increased (AOR = 4.8; CI = 1.8, 13.1) and decreased use (AOR = 3.3; CI = 1.5, 7.5). The pandemic has had a mixed impact on cannabis use, with participants reporting both increased and decreased use. Efforts may target users of vaporized and edible cannabis, co-users of cannabis and tobacco, and young adults to prevent increased cannabis use during the pandemic.
Collapse
Affiliation(s)
- Nhung Nguyen
- Center for Tobacco Control Research and Education, and Division of General Internal Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Salomeh Keyhani
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
- San Francisco Veterans Affairs Health Care System, San Francisco, CA, USA
| | - Pamela M. Ling
- Center for Tobacco Control Research and Education, and Division of General Internal Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Katherine J. Hoggatt
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
- San Francisco Veterans Affairs Health Care System, San Francisco, CA, USA
| | - Deborah Hasin
- Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Beth E. Cohen
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
- San Francisco Veterans Affairs Health Care System, San Francisco, CA, USA
| |
Collapse
|
9
|
Azagba S, Shan L. Trends in the frequency of cigar use among US adults, 1998/99-2018/19. Addict Behav 2022; 131:107331. [PMID: 35413488 DOI: 10.1016/j.addbeh.2022.107331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 03/31/2022] [Accepted: 04/04/2022] [Indexed: 11/20/2022]
Abstract
There is limited information on the trend in the frequency of cigar use from the literature. This study aimed to examine the trends of cigar use frequency among U.S. adults. Data were obtained from 1998/99 to 2018/19 Tobacco Use Supplement to the Current Population Survey (n = 21,940). We generated estimates of the cigar use frequency among current cigar users for each survey year for the full sample, as well as by sociodemographic characteristics. Linear regression models were used to test the statistical significance of the linear trend. Additional analyses were conducted among someday users only. Over the study period, the cigar use frequency among current users was stable at approximately 10 days in the past 30 days. In 1998/1999, male current cigar users and someday cigar users reported using cigars for 9.6 and 5.2 days in the past 30 days, respectively, which decreased to 9.2 and 4.7 days in 2018/2019. In contrast, a significant increasing trend was found among female current cigar users and someday cigar users from 8.4 and 4.7 days to 13.6 and 6.2 days from 1998/1999 to 2018/2019. Likewise, we found that the cigar use frequency increased among current cigar and cigarette users over the study period. Overall, cigar use frequency is relatively stable. Over time, cigar use frequency decreased significantly among males, while it increased among females. Our findings further highlight that targeted efforts are needed to reduce the disproportionate use of cigars.
Collapse
|
10
|
Shi S, Zhu Q, Liao S, Zhu X, Tang X, Zhou Y. The association between dietary fiber intake and the concentrations of aldehydes in serum. Environ Sci Pollut Res Int 2022; 29:25790-25798. [PMID: 34846670 DOI: 10.1007/s11356-021-17638-5] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 11/16/2021] [Indexed: 06/13/2023]
Abstract
Aldehydes have been shown to be potentially carcinogenic, mutagenic, and cardiotoxic to humans. Dietary fiber reduces exposure to certain environmental pollutants and has been widely used to improve various metabolic disorders. However, the effects of dietary fiber on serum concentrations of aldehydes remain unexplored. Data was collected from the National Health and Nutrition Examination Survey (NHANES) 2013-2014. Generalized linear regression and restricted cubic spline models were performed to elucidate the association of dietary fiber intake with the serum concentration of aldehydes. After fully adjusting for age, sex, education level, race, smoking status, alcohol use, diabetes, hypertension, body mass index, energy intake, poverty-income ratio, and physical activity, dietary fiber intake had a strong negative association with serum levels of isopentanaldehyde and propanaldehyde and a positive association with serum levels of benzaldehyde. The estimated increases in the mean log2-unit (ng/mL) of aldehydes for each fold increase in dietary fiber were -0.140 (95% confidence interval [CI]: -0.195 to -0.085) for isopentanaldehyde, -0.060 (95% CI: -0.099 to -0.015) for propanaldehyde, and 0.084 (95% CI: 0.017 to 0.150) for benzaldehyde, respectively. No significant association was observed between dietary fiber intake and the concentration of any other aldehydes. These results demonstrate that dietary fiber reduces the concentration of certain aldehydes in serum.
Collapse
Affiliation(s)
- Shi Shi
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Guangzhou Road 300, Nanjing, 210029, China
| | - Qingqing Zhu
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Guangzhou Road 300, Nanjing, 210029, China
| | - Shengen Liao
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Guangzhou Road 300, Nanjing, 210029, China
| | - Xu Zhu
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Guangzhou Road 300, Nanjing, 210029, China
| | - Xiaosu Tang
- Jiangxi Environmental Engineering Vocational College, Ganzhou, 341000, China
| | - Yanli Zhou
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Guangzhou Road 300, Nanjing, 210029, China.
| |
Collapse
|
11
|
Kim H, Yu B, Li X, Wong KE, Boerwinkle E, Seidelmann SB, Levey AS, Rhee EP, Coresh J, Rebholz CM. Serum metabolomic signatures of plant-based diets and incident chronic kidney disease. Am J Clin Nutr 2022; 116:151-164. [PMID: 35218183 PMCID: PMC9257476 DOI: 10.1093/ajcn/nqac054] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [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: 11/11/2021] [Accepted: 02/24/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Greater adherence to plant-based diets is associated with a lower risk of incident chronic kidney disease (CKD). Metabolomics can help identify blood biomarkers of plant-based diets and enhance understanding of underlying mechanisms. OBJECTIVES Using untargeted metabolomics, we aimed to identify metabolites associated with 4 plant-based diet indices (PDIs) (overall PDI, provegetarian diet, healthful PDI, and unhealthful PDI) and incident CKD in 2 subgroups within the Atherosclerosis Risk in Communities study. METHODS We calculated 4 PDIs based on participants' responses on an FFQ. We used multivariable linear regression to examine the association between 4 PDIs and 374 individual metabolites, adjusting for confounders. We used Cox proportional hazards regression to evaluate associations between PDI-related metabolites and incident CKD. Estimates were meta-analyzed across 2 subgroups (n1 = 1762; n2 = 1960). We calculated C-statistics to assess whether metabolites improved the prediction of those in the highest quintile compared to the lower 4 quintiles of PDIs, and whether PDI- and CKD-related metabolites predicted incident CKD beyond the CKD prediction model. RESULTS We identified 82 significant PDI-metabolite associations (overall PDI = 27; provegetarian = 17; healthful PDI = 20; unhealthful PDI = 18); 11 metabolites overlapped across the overall PDI, provegetarian diet, and healthful PDI. The addition of metabolites improved prediction of those in the highest quintile as opposed to the lower 4 quintiles of PDIs compared with participant characteristics alone (range of differences in C-statistics = 0.026-0.104; P value ≤ 0.001 for all tests). Six PDI-related metabolites (glycerate, 1,5-anhydroglucitol, γ-glutamylalanine, γ-glutamylglutamate, γ-glutamylleucine, γ-glutamylvaline), involved in glycolysis, gluconeogenesis, pyruvate metabolism, and γ-glutamyl peptide metabolism, were significantly associated with incident CKD and improved prediction of incident CKD beyond the CKD prediction model (difference in C-statistics for 6 metabolites = 0.005; P value = 0.006). CONCLUSIONS In a community-based study of US adults, we identified metabolites that were related to plant-based diets and predicted incident CKD. These metabolites highlight pathways through which plant-based diets are associated with incident CKD.
Collapse
Affiliation(s)
- Hyunju Kim
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA,Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD, USA
| | - Bing Yu
- Department of Epidemiology, Human Genetics & Environmental Sciences, University of Texas Health Sciences Center at Houston School of Public Health, Houston, TX, USA
| | - Xin Li
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD, USA
| | | | - Eric Boerwinkle
- Department of Epidemiology, Human Genetics & Environmental Sciences, University of Texas Health Sciences Center at Houston School of Public Health, Houston, TX, USA
| | - Sara B Seidelmann
- College of Physicians & Surgeons, Columbia University, New York, NY, USA
| | - Andrew S Levey
- Division of Nephrology, Tufts Medical Center, Boston, MA, USA
| | - Eugene P Rhee
- Nephrology Division and Endocrine Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Josef Coresh
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA,Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD, USA,Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | | |
Collapse
|
12
|
Yin T, Zhu X, Xu D, Lin H, Lu X, Tang Y, Shi M, Yao W, Zhou Y, Zhang H, Li X. The Association Between Dietary Antioxidant Micronutrients and Cardiovascular Disease in Adults in the United States: A Cross-Sectional Study. Front Nutr 2022; 8:799095. [PMID: 35096944 PMCID: PMC8791653 DOI: 10.3389/fnut.2021.799095] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [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: 10/21/2021] [Accepted: 12/15/2021] [Indexed: 12/18/2022] Open
Abstract
Background: Antioxidant micronutrients represent an important therapeutic option for the treatment of oxidative stress-associated cardiovascular diseases (CVDs). However, few studies have evaluated the relationship between the levels of multiple dietary antioxidants and CVDs. Objective: The study therefore aimed to evaluate associations between dietary antioxidants and total and specific CVDs among a nationally representative sample of adults in the US. Design: In total, 39,757 adults (>20 years) were included in this cross-sectional study from the 2005–2018 National Health and Nutrition Examination Survey. We analyzed dietary recall of 11 antioxidant micronutrients in this population. Multivariate logistic and weighted quantile sum (WQS) regression were both applied to examine the relationships between these antioxidants, alone and in combination, with the prevalence of all CVDs and specific CVDs. The linearity of these correlations was also explored using restricted cubic spline (RCS) regression. Results: Multivariate logistic models showed that, compared with the lowest quartile, the levels of 11 antioxidants in the highest quartile were independently associated with decreased total CVD (all P < 0.05). The WQS index showed that, when considered together, the 11 micronutrients were negatively correlated with total CVD (P < 0.001) and five specific CVDs (all P < 0.05), and selenium had the strongest association (weight = 0.219) with total CVD. Moreover, the RCS model demonstrated that iron, zinc and copper were all negatively and non-linearly correlated with total CVD, while the eight other micronutrients had non-significant, linear, negative relationships with total CVD (P for non-linearity >0.05). A piecewise binary logistic regression analysis showed that the inflection points in the relationships between CVD and iron, zinc and copper were 7.71, 6.61, and 0.74 mg/day, respectively. Conclusions: Our findings suggested that high levels of combined dietary antioxidant micronutrients are associated with decreased prevalence of CVDs, and that selenium has the greatest contribution to this association.
Collapse
Affiliation(s)
- Ting Yin
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China
| | - Xu Zhu
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China
| | - Dong Xu
- Department of Vascular Surgery, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Zhejiang, China
| | - Huapeng Lin
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Xinyi Lu
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China
| | - Yuan Tang
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China
| | - Mengsha Shi
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China
| | - Wenming Yao
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China
| | - Yanli Zhou
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China
| | - Haifeng Zhang
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China.,Department of Cardiology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, China
| | - Xinli Li
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China
| |
Collapse
|
13
|
Azagba S, Shan L. Disparities in the receipt of medical doctors' advice to quit smoking in the U.S., 1992-2019. Addict Behav 2022; 125:107145. [PMID: 34700153 DOI: 10.1016/j.addbeh.2021.107145] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 04/04/2021] [Revised: 09/21/2021] [Accepted: 10/07/2021] [Indexed: 11/17/2022]
Abstract
There has been significant progress in reducing tobacco use in the last few decades. However, there is a considerable concern that the decrease in cigarette use has not been distributed equally across certain groups. The current study examines sociodemographic trends in the receipt of advice to quit from healthcare professionals. Data were drawn from the 1992-2019 Tobacco Use Supplement to the Current Population Survey (n = 192,398). Cochran-Armitage tests were used to assess changes in the prevalence over time in the population and by demographic characteristics. Multivariable logistic regression was used to examine factors associated with the receipt of advice to quit smoking. The prevalence of receiving advice to quit increased significantly from 50.1% in 1992/1993 to 63.9% in 2018/2019. Results showed differences in the receipt of quit advice from medical doctors by demographic characteristics, with a significant increase in smoking quit advice for all races (p < 0.0001). Current Hispanic smokers consistently had lower rates of receiving advice to quit than non-Hispanics throughout the study period. Multivariable analysis showed that in 2018/19, male (aOR 0.89; 95% CI 0.81-0.98) and Hispanic (aOR 0.73; 95% CI 0.61-0.88) current smokers were less likely to receive advice to quit. Those older and living in metropolitan areas had higher odds of receiving advice to quit. Findings that Hispanics appear to be significantly less likely to receive advice to quit from health care professionals indicate that these populations might need additional targeted efforts.
Collapse
Affiliation(s)
- Sunday Azagba
- Ross and Carol Nese College of Nursing, Penn State, University Park, PA 16802, USA.
| | - Lingpeng Shan
- Division of Biostatistics, College of Public Health, The Ohio State University, USA
| |
Collapse
|
14
|
Park S, Lee SH, Yaroch AL, Blanck HM. Reported Changes in Eating Habits Related to Less Healthy Foods and Beverages during the COVID-19 Pandemic among US Adults. Nutrients 2022; 14. [PMID: 35276885 DOI: 10.3390/nu14030526] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 01/20/2022] [Accepted: 01/24/2022] [Indexed: 02/04/2023] Open
Abstract
Background: The COVID-19 pandemic has triggered stress, anxiety, and disruption to many individuals’ daily lives, which might impact eating habits. Objective: To examine changes in eating habits related to less healthy foods and beverages during the early phase of the COVID-19 pandemic among US adults. Design: Cross-sectional study. Participants/setting: Authors used SummerStyles data gathered in June 2020 among 3916 US adults (≥18 years). Main outcome measures: The outcome of interest was the reported frequency of consuming more (1) unhealthy snacks and desserts including chips, cookies, and ice cream and (2) sugar-sweetened beverages (SSBs) like regular soda, fruit drinks, sports/energy drinks, sweetened coffee/teas during the COVID-19 pandemic. Responses were categorized as Never/Rarely, Sometimes, or Often/Always. Explanatory variables were sociodemographics, weight status, and census regions. Statistical analyses performed: We used multinomial regressions to calculate adjusted odds ratios (AOR) for Sometimes or Often/Always consuming more unhealthy snacks/desserts (vs. Never/Rarely); and Sometimes or Often/Always more SSBs (vs. Never/Rarely). Results: Overall, 36% of adults reported sometimes consuming more unhealthy snacks/desserts; 16% did so often/always. Twenty-two percent of adults reported sometimes drinking more SSBs; 10% did so often/always. Factors significantly associated with higher odds of reporting often/always consuming more unhealthy snacks/desserts were younger adults (AOR range = 1.51−2.86 vs. adults ≥65 years), females (AOR = 1.58 vs. males), non-Hispanic Black (AOR = 1.89 vs. non-Hispanic White), lower household income (AOR = 2.01 for <USD 35,000 vs. ≥USD 100,000), and obesity (AOR = 1.56 vs. underweight/healthy weight). Factors significantly associated with odds of Often/Always drinking more SSBs were being younger (AOR range = 2.26−4.39 vs. adults ≥65 years), non-Hispanic Black (AOR = 3.25 vs. non-Hispanic White), Hispanic (AOR = 1.75 vs. non-Hispanic White), non-Hispanic Other race/ethnicity (AOR = 2.41 vs. non-Hispanic White), lower education (AOR = 2.03 for ≤high school; AOR = 1.80 for some college vs. college graduate), lower household income (AOR range = 1.64−3.15 vs. ≥USD 100,000), and obesity (AOR = 1.61 vs. underweight/healthy weight). Conclusions: Consuming more sugary foods and SSBs during the first phase of the pandemic was higher in younger adults, lower-income adults, people of racial/ethnic minority groups, and adults with obesity. Dietary shifts to less healthy foods and drinks may influence metabolic health if sustained long-term. Implementing strategies to support individual’s healthy eating habits during the ongoing pandemic and the pandemic recovery may benefit health and wellness.
Collapse
|
15
|
O'Brien DM, Sagi-Kiss V, Palma-Duran SA, Cunningham C, Barrett B, Johnston CS, Midthune D, Kipnis V, Freedman LS, Tasevska N. An evaluation of the serum carbon isotope ratio as a candidate predictive biomarker of the dietary animal protein ratio (animal protein/total protein) in a 15-day controlled feeding study of US adults. Am J Clin Nutr 2022; 115:1134-1143. [PMID: 35030258 PMCID: PMC8970990 DOI: 10.1093/ajcn/nqac004] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 08/30/2021] [Accepted: 01/10/2022] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND The serum natural abundance carbon isotope ratio (CIR) was recently identified as a candidate biomarker of animal protein intake in postmenopausal women. Such a biomarker would help clarify the relation between dietary protein source (plant or animal) and chronic disease risk. OBJECTIVES We aimed to evaluate the performance of the serum CIR as a biomarker of dietary protein source in a controlled feeding study of men and women of diverse age and BMI. METHODS We conducted a 15-d feeding study of 100 adults (age: 18-70 y, 55% women) in Phoenix, AZ. Participants were provided individualized diets that approximated habitual food intakes. Serum was collected at the end of the feeding period for biomarker measurements. RESULTS Median [IQR] animal protein intake was 67 g/d [55-88 g/d], which was 64% of total protein. The serum CIR was positively correlated with animal protein and inversely correlated with plant protein intake, leading to a strong correlation (r2 = 0.76) with the dietary animal protein ratio (APR; animal/total protein). Regressing serum CIR on the APR, serum nitrogen isotope ratio (NIR), gender, age, and body weight generated an R2 of 0.78. Following the measurement error model for predictive biomarkers, the resulting regression equation was then inverted to develop a calibrated biomarker equation for APR. Added sugars ratio (added/total sugars intake) and corn intakes also influenced the serum CIR but to a much lesser degree than the APR; variations in these intakes had only small effects on biomarker-estimated APR. CONCLUSIONS Based on our findings in this US cohort of mixed sex and age, we propose the serum CIR alongside NIR as a predictive dietary biomarker of the APR. We anticipate using this biomarker to generate calibrated estimates based on self-reported intake and ultimately to obtain more precise disease risk estimates according to dietary protein source.
Collapse
Affiliation(s)
| | - Virag Sagi-Kiss
- Present address for VS-K: School of Medicine, Imperial College London, London, United Kingdom
| | | | | | - Brian Barrett
- Information Management Services, Inc., Rockville, MD, USA
| | - Carol S Johnston
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA
| | - Douglas Midthune
- Division of Cancer Prevention, National Cancer Institute, Bethesda, MD, USA
| | - Victor Kipnis
- Division of Cancer Prevention, National Cancer Institute, Bethesda, MD, USA
| | - Laurence S Freedman
- Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer, Israel
| | - Natasha Tasevska
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA
| |
Collapse
|
16
|
King JL, Shan L, Azagba S. Trends in sexual orientation disparities in cigarette smoking: Intersections between race/ethnicity and sex. Prev Med 2021; 153:106760. [PMID: 34352307 PMCID: PMC9008567 DOI: 10.1016/j.ypmed.2021.106760] [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: 01/13/2021] [Revised: 07/17/2021] [Accepted: 07/30/2021] [Indexed: 11/17/2022]
Abstract
Cigarette smoking is disproportionately high among sexual minority populations, but it is unclear whether these disparities exist among race/ethnicity subgroups. This study examined trends in sexual orientation disparities in cigarette smoking by race/ethnicity. Data are from the 2014-2019 Behavioral Risk Factor Surveillance System (N = 1,194,768). Trend analyses compared cigarette smoking by race/ethnicity (non-Hispanic White, non-Hispanic Black, Hispanic, non-Hispanic other) and sexual orientation (straight, lesbian or gay, bisexual, something else/don't know/refused). Multivariable analyses examined associations between sexual orientation and cigarette use for each race/ethnicity, controlling for other sociodemographic characteristics. Between 2014 and 2019, lesbian or gay, and bisexual populations consistently had higher smoking rates than straight populations, which held across race/ethnicity. Among non-Hispanic White adults, lesbians (OR = 1.51, 95% CI = 1.29, 1.76), bisexual females (OR = 1.56, 95% CI = 1.39, 1.75), gay (OR = 1.38, 95% CI = 1.22, 1.55), and bisexual males (OR = 1.22, 95% CI = 1.04, 1.43) had higher odds of smoking compared those self-identifying as straight. Among non-Hispanic Black adults, lesbians (OR = 1.90, 95% CI =1.33, 2.73) and bisexual females (OR = 1.85, 95% CI =1.42, 2.41) were more likely to currently smoke. Among Hispanic adults, those self-identifying as lesbian or gay (OR = 1.58, 95% CI = 1.19, 2.09) or bisexual (OR = 2.40, 95% CI = 1.88, 3.07) were more likely to currently smoke, though the associations were not significant in Hispanic males. Disparities in cigarette smoking by race/ethnicity and sexual orientation suggest that aggregating these groups mask important differences and limit efforts to target those most at risk.
Collapse
Affiliation(s)
- Jessica L King
- Department of Health, Kinesiology, & Recreation, University of Utah, Salt Lake City, UT, USA
| | - Lingpeng Shan
- Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Sunday Azagba
- Penn State College of Nursing, University Park, PA, USA.
| |
Collapse
|
17
|
Titcomb TJ, Liu B, Lehmler HJ, Snetselaar LG, Bao W. Environmental Nickel Exposure and Diabetes in a Nationally Representative Sample of US Adults. Expo Health 2021; 13:697-704. [PMID: 35685677 PMCID: PMC9175810 DOI: 10.1007/s12403-021-00413-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 05/27/2021] [Accepted: 06/17/2021] [Indexed: 06/15/2023]
Abstract
Laboratory studies have shown that nickel exposure may adversely affect glucose metabolism. However, studies about the effects of environmental nickel exposure on diabetes pathogenesis in humans are sparse. We aimed to evaluate the association of urinary nickel concentrations, as a biomarker of environmental nickel exposure, and diabetes in a nationally representative sample of US adults. The data from a nationally representative population (n = 1585) in the National Health and Nutrition Examination Survey 2017-18 were used. Diabetes (n = 330) was defined as self-reported physician's diagnosis, HbA1c ≥ 6.5%, fasting plasma glucose ≥ 126 mg/dL, or 2-h plasma glucose ≥ 200 mg/dL. Urinary nickel concentrations were determined by inductively coupled plasma mass spectrometry. Logistic regression with sample weights was used to estimate the odds ratios (ORs) of diabetes and 95% confidence intervals (CIs). Urinary nickel concentrations were higher in individuals with diabetes (weighted median 1.23 μg/L) than those without diabetes (1.01 μg/L). After adjustment for urinary creatinine and other risk factors for diabetes, the OR of diabetes comparing the highest with lowest quartile of urinary nickel concentrations was 2.70 (95% CI 1.39-5.24; Ptrend = 0.03). Environmental nickel exposure is positively and significantly associated with diabetes in U.S. adults.
Collapse
Affiliation(s)
- Tyler J. Titcomb
- Department of Epidemiology, College of Public Health, University of Iowa, 145 North Riverside Drive, Room S431 CPHB, Iowa City, IA 52242, USA
- Department of Internal Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA, USA
- Fraternal Order of Eagles Diabetes Research Center, University of Iowa, Iowa City, IA, USA
| | - Buyun Liu
- Department of Epidemiology, College of Public Health, University of Iowa, 145 North Riverside Drive, Room S431 CPHB, Iowa City, IA 52242, USA
| | - Hans-Joachim Lehmler
- Department of Occupational and Environmental Health, College of Public Health, University of Iowa, Iowa City, IA, USA
- Environmental Health Sciences Research Center, University of Iowa, Iowa City, IA, USA
| | - Linda G. Snetselaar
- Department of Epidemiology, College of Public Health, University of Iowa, 145 North Riverside Drive, Room S431 CPHB, Iowa City, IA 52242, USA
- Fraternal Order of Eagles Diabetes Research Center, University of Iowa, Iowa City, IA, USA
| | - Wei Bao
- Department of Epidemiology, College of Public Health, University of Iowa, 145 North Riverside Drive, Room S431 CPHB, Iowa City, IA 52242, USA
- Fraternal Order of Eagles Diabetes Research Center, University of Iowa, Iowa City, IA, USA
- Environmental Health Sciences Research Center, University of Iowa, Iowa City, IA, USA
| |
Collapse
|
18
|
Wu X, Wang W, Zhang D, Zhu F. Nutritional status, lifestyle habits and cancer mortality: a population-based prospective cohort study. Eur J Nutr 2021. [PMID: 34791510 DOI: 10.1007/s00394-021-02739-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 11/04/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE We aimed to investigate the relationship between overall nutritional status and cancer mortality. METHODS A total of 12 262 US adults from six consecutive surveys of the National Health and Nutrition Examination Survey (NHANES 2003-2014) were analyzed. The overall health nutritional biomarkers index (HNBI) score, capturing characteristics of 17 biomarkers was developed to assess the overall nutritional status. The lower the HNBI score, the healthier nutritional status would be. Hazard ratio (HR) and 95% confidence intervals (95% CIs) were calculated by Cox proportional hazards regression models to evaluate the association between the HNBI score and cancer mortality. RESULTS The lower overall HNBI score was associated with decreased risk of cancer mortality, compared with participants in the 4th quartile of overall HNBI score, the HR (95% CIs) for participants in the 1st quartiles was 0.54 (0.33-0.89) (P-trend = 0.019). Healthier lifestyle habits and not obesity interacted with HNBI score, compared with participants with higher HNBI score and smoking currently/not exercising regularly/obesity, participants with lower HNBI score and not smoking currently/exercising regularly/not obesity were associated with lower risk of cancer mortality, the HR (95% CIs) were 0.43 (0.26-0.73), 0.57 (0.33-0.97), and 0.62 (0.47-0.97), respectively. These significant associations remained among participants who were followed-up more than 2 years. CONCLUSION Our findings suggested that healthier overall nutritional status was associated with lower risk of cancer mortality among US adults. Not smoking, exercise regularly and not obesity interacted with overall nutritional status. Adherence to better overall nutritional status, lifestyle habits and optimal weight would prevent premature death from cancer.
Collapse
|
19
|
Ha K, Sakaki JR, Chun OK. Nutrient Adequacy Is Associated with Reduced Mortality in US Adults. J Nutr 2021; 151:3214-3222. [PMID: 34383909 DOI: 10.1093/jn/nxab240] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 03/03/2021] [Revised: 04/14/2021] [Accepted: 06/25/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Americans are underconsuming essential nutrients while overconsuming several nutrients, including sodium, saturated fat, and added sugars. Suboptimal nutrition may be linked with mortality risk; however, few studies have evaluated the associations of underconsumed and overconsumed nutrients in a comprehensive manner among the US population. OBJECTIVES This study investigated the association between nutrient intake through diet and mortality focusing on adequacy, moderation, and macronutrient quality in US adults. METHODS Based on the 1999-2010 NHANES, 20,602 adults aged ≥30 y were followed up until December 2015. Nutrient intake was assessed using a 1-d 24-h dietary recall. Adequacy of major underconsumed nutrients in the United States was evaluated using the RDA (percent of RDA) or Adequate Intake (percent of AI). Overconsumed nutrients for which moderation is needed were assessed based on various dietary recommendations. Macronutrient quality was evaluated using the ratio of carbohydrates to dietary fiber, essential amino acids, and EPA + DHA. The association between nutrient intake and mortality was evaluated using Cox proportional hazards regression analysis. RESULTS Higher intakes of vitamin E, magnesium, iron, dietary fiber, and potassium relative to the RDA/AI were associated with lower all-cause mortality. High intake of vitamin A (tertile 3: ≥80.1% of RDA) was associated with lower mortality from cardiovascular disease (CVD; HR: 0.75; 95% CI: 0.57, 0.99) and cancer (HR: 0.76; 95% CI: 0.62, 0.94), and high intake of calcium (tertile 3: ≥87.8% of RDA) was inversely associated with cancer mortality (HR: 0.72; 95% CI: 0.56, 0.93). Higher intakes of essential amino acids and EPA + DHA evaluated as quartiles were inversely associated with all-cause and CVD mortality. CONCLUSIONS These findings suggest that higher intakes of underconsumed nutrients and improving macronutrient quality are associated with lower risk of CVD and cancer deaths in US adults.
Collapse
Affiliation(s)
- Kyungho Ha
- Department of Food Science and Nutrition, Jeju National University, Jeju City, Jeju, South Korea.,Department of Nutritional Sciences, University of Connecticut, Storrs, CT, USA
| | - Junichi R Sakaki
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT, USA
| | - Ock K Chun
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT, USA
| |
Collapse
|
20
|
Ricci C, Leitzmann MF, Freisling H, Schutte AE, Schutte R, Kruger SH, Smuts CM, Pieters M. Diet and sedentary behaviour in relation to mortality in US adults with a cardiovascular condition: results from the National Health and Nutrition Examination Survey linked to the US mortality registry. Br J Nutr 2020; 124:1329-1337. [PMID: 32600485 DOI: 10.1017/s0007114520002391] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 11/06/2022]
Abstract
CVD is the most common chronic condition and the highest cause of mortality in the USA. The aim of the present work was to investigate diet and sedentary behaviour in relation to mortality in US CVD survivors. The National Health and Nutrition Examination Surveys conducted between 1999 and 2014 linked to the US mortality registry updated to 2015 were investigated. Multivariate adjusted Cox regression was used to derive mortality hazards in relation to sedentary behaviour and nutrient intake. A multiplicative and additive interaction analysis was conducted to evaluate how sedentariness and diet influence mortality in US CVD survivors. A sample of 2473 participants followed for a median period of 5·6 years resulted in 761 deaths, and 199 deaths were due to CVD. A monotone increasing relationship between time spent in sedentary activities and mortality risk was observed for all-cause and CVD mortality (hazard ratio (HR) = 1·20, 95 % CI 1·09, 1·31 and HR = 1·19, 95 % CI 1·00, 1·67, respectively). Inverse mortality risks in the range of 22-34 % were observed when comparing the highest with the lowest tertile of dietary fibre, vitamin A, carotene, riboflavin and vitamin C. Sedentariness below 360 min/d and dietary fibre and vitamin intake above the median interact on an additive scale influencing positively all-cause and CVD mortality risk. Reduced sedentariness in combination with a varied diet rich in dietary fibre and vitamins appears to be a useful strategy to reduce all-cause and CVD mortality in US CVD survivors.
Collapse
Affiliation(s)
- Cristian Ricci
- Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa
- Pediatric Epidemiology, Department of Pediatrics, University Medicine Leipzig, Leipzig, Germany
| | - Michael F Leitzmann
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Heinz Freisling
- Nutritional Methodology and Biostatistics Group, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Aletta E Schutte
- Hypertension in Africa Research Team, MRC Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
- Medical Research Council Hypertension and Cardiovascular Disease Research Unit, North-West University, Potchefstroom, South Africa
| | - Rudolph Schutte
- School of Allied Health, Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, Cambridge, UK
| | - Salome H Kruger
- Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa
- Medical Research Council Hypertension and Cardiovascular Disease Research Unit, North-West University, Potchefstroom, South Africa
| | - Cornelius M Smuts
- Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa
| | - Marlien Pieters
- Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa
| |
Collapse
|
21
|
Huang Q, Braffett BH, Simmens SJ, Young HA, Ogden CL. Dietary Polyphenol Intake in US Adults and 10-Year Trends: 2007-2016. J Acad Nutr Diet 2020; 120:1821-1833. [PMID: 32807722 DOI: 10.1016/j.jand.2020.06.016] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 06/04/2020] [Accepted: 06/09/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND Polyphenols are a class of phytochemicals that have antioxidant, anti-inflammatory, anticancer, and antiviral properties. Previous research suggests that dietary polyphenol intake is protective against major chronic diseases. To our knowledge, no data on polyphenol intake for the US adult population are available. OBJECTIVE This study explored usual dietary polyphenol intake among US adults in 2013-2016 and examined trends in intake during 2007-2016 by demographic characteristics, and identified major dietary sources of polyphenols. DESIGN The National Health and Nutrition Examination Survey is a series of cross-sectional surveys representative of the civilian noninstitutionalized US population. PARTICIPANTS/SETTING This study included 9,773 adults aged 20 years and older. MAIN OUTCOME MEASURES Dietary and supplement data were obtained from two 24-hour dietary recalls. Polyphenol intake was estimated using the Phenol Explorer Database and adjusted for total energy intake. STATISTICAL ANALYSIS PERFORMED Usual intake was estimated both overall and by demographic characteristics using the National Cancer Institute method. Trends in intake on a given day over 10 years were evaluated using regression analysis. The complex survey design was incorporated in all analyses. RESULTS In 2013-2016, the usual intake of dietary polyphenols was a mean (standard error) of 884.1 (20.4) mg per 1,000 kcal/d. Polyphenol intake was higher in adults 40 years and older, women, non-Hispanic White adults, and college graduates. During 2007-2016, the mean daily polyphenol intake did not change significantly over time for overall and demographic groups. Main polyphenol classes consumed were phenolic acids (mean [standard error] of 1,005.6 [34.3] mg/d) and flavonoids (mean [standard error] of 379.1 [10.7] mg/d). Foods and beverages contributed 99.8% of polyphenol intake, with coffee (39.6%), beans (9.8%), and tea (7.6%) as major dietary contributors. CONCLUSION Findings from this study suggest that polyphenol intake is consistent with the low intake of fruits, vegetables, and whole grains in the US population, and provide more evidence of the need for increased consumption of these food groups.
Collapse
|
22
|
Han S, Wu L, Wang W, Li N, Wu X. Trends in Dietary Nutrients by Demographic Characteristics and BMI among US Adults, 2003-2016. Nutrients 2019; 11:nu11112617. [PMID: 31683900 PMCID: PMC6893675 DOI: 10.3390/nu11112617] [Citation(s) in RCA: 15] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 10/28/2019] [Accepted: 10/29/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Limited data were available on trends of US dietary nutrients especially for specific subgroups; Methods: Dietary intakes of energy and 36 kinds of nutrients were analyzed in the National Health and Nutrition Examination Survey (NHANES) from 2003 to 2016 and by age and sex, socioeconomic status, race/ethnicity, and body mass index, which were evaluated by whether not they meet the dietary reference intakes (DRIs); Results: Significantly decreased trends were observed for carbohydrate, total sugars, fiber, calcium, magnesium, phosphorus, selenium, vitamin B6, E, K, and choline, while increased trends were observed for saturated fatty acids, iron, zinc, copper, potassium, sodium, vitamin B1, B2, B12, C and folate DFE (as dietary folate equivalents). A decreased trend of exceeding the estimated energy requirement was found. Population with low socioeconomic status and non-Hispanic blacks accounted for the largest proportion not meeting DRIs for most of nutrients; Conclusions: Most dietary nutrients were improved among US adults from 2003 to 2016 but were still far from optimal levels. Populations with low socioeconomic status and non-Hispanic blacks should be paid more attention to improve their dietary nutrient intake.
Collapse
Affiliation(s)
- Shan Han
- Department of Nutrition and Food Hygiene, the National Key Discipline, School of Public Health, Harbin Medical University, Harbin 150081, China.
| | - Lanlan Wu
- Department of Nutrition and Food Hygiene, the National Key Discipline, School of Public Health, Harbin Medical University, Harbin 150081, China.
| | - Wenjie Wang
- Department of Nutrition and Food Hygiene, the National Key Discipline, School of Public Health, Harbin Medical University, Harbin 150081, China.
| | - Na Li
- Department of Nutrition and Food Hygiene, the National Key Discipline, School of Public Health, Harbin Medical University, Harbin 150081, China.
| | - Xiaoyan Wu
- Department of Nutrition and Food Hygiene, the National Key Discipline, School of Public Health, Harbin Medical University, Harbin 150081, China.
| |
Collapse
|
23
|
Yu L, Zhou L, Zhou D, Hu G. Nonlinear relationship between triglyceride/high-density lipoprotein cholesterol ratio and chronic kidney disease in US adults: a National Health and Nutrition Examination Survey investigation. Int Urol Nephrol 2019; 51:2005-2014. [PMID: 31538278 DOI: 10.1007/s11255-019-02287-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 05/13/2019] [Accepted: 09/15/2019] [Indexed: 01/06/2023]
Abstract
PURPOSE Published data on the association between triglycerides/high-density lipoprotein cholesterol (TG/HDL-C) ratio and chronic kidney disease (CKD) in US populations are limited. We examined the association between TG/HDL-C ratio and the prevalence of CKD using US National Health and Nutrition Examination Survey (NHANES) database. METHODS This cross-sectional study included 13,780 US adults from NHANES (1999-2006). CKD was defined as an estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m2 or albuminuria. Multivariable logistic regression models were used to examine the relationship between TG/HDL-C ratio and CKD. A generalized additive model (GAM) and smooth curve fitting (penalized spline method) and a two-piecewise logistic regression models were also conducted to address for nonlinearity between TG/HDL-C ratio and CKD. RESULTS The prevalence of CKD was 15.8%. Multiple logistic analyses showed that showed that TG/HDL-C ratio was associated with 5% increased prevalence of CKD. Analyses using restricted cubic spline showed a saturation and nonlinear association between TG/HDL-C ratio and CKD. The inflection point for the curve was found at a TG/HDL-C ratio level of 6.68. The ORs (95% CIs) for CKD were 1.08 (1.04, 1.13) and 0.97 (0.89, 1.05) to the left and right of the inflection point, respectively. None of all stratified variables showed significant effect modification on the association between TG/HDL-C ratio and CKD (P-interaction > 0.05). CONCLUSIONS Our study suggested saturated effects of TG/HDL-C ratio on the prevalence of CKD among US adults. TG/HDL-C ratio less than 6.68 was positively and independently associated with CKD.
Collapse
Affiliation(s)
- Le Yu
- Department of Rheumatology, The Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Nanchang, Jiangxi, 330006, China
| | - Limin Zhou
- Department of Emergency, The First Affiliated Hospital of Nanchang University, No. 17, Yongwaizheng Street, Donghu District, Nanchang, Jiangxi, 330000, China
| | - Di Zhou
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, No. 38, Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Guiping Hu
- School of Medicine, Beihang University, 37 Xueyuan Road, Haidian District, Beijing, 100191, China. .,Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Beihang University, 37 Xueyuan Road, Haidian District, Beijing, 100191, China.
| |
Collapse
|
24
|
Melough MM, Chung SJ, Fernandez ML, Chun OK. Association of eggs with dietary nutrient adequacy and cardiovascular risk factors in US adults. Public Health Nutr 2019; 22:2033-42. [PMID: 30834848 DOI: 10.1017/S1368980019000211] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Whole eggs are rich sources of several micronutrients. However, it is not well known how egg consumption contributes to overall nutrient adequacy and how it may relate to CVD risk factors. Therefore, the present study aimed to determine how whole egg consumption contributes to nutrient intakes and to assess its association with CVD risk factors in US adults. DESIGN Cross-sectional study. SETTING The study was conducted using data from the National Health and Nutrition Examination Survey (NHANES) 2003-2012, a nationally representative survey of the US civilian population.ParticipantsAdults who completed two dietary recalls and provided information on relevant sociodemographic factors were included in the study (n 21 845). RESULTS Approximately 73 % of adults were classified as whole egg consumers. Egg consumption was associated with greater intakes of protein, saturated fat, mono- and polyunsaturated fats, Fe, Zn, Ca, Se, choline, and several other vitamins and minerals. Egg consumption was associated with a higher likelihood of meeting or exceeding recommendations for several micronutrients. Egg intake was positively associated with dietary cholesterol consumption, but not with serum total cholesterol (TC) when adjusted for multiple potential confounders. In multiple linear regression analyses, TAG, TAG:HDL-cholesterol and TC:HDL-cholesterol were significantly lower with greater egg consumption. Egg consumption had no significant relationship with LDL-cholesterol or C-reactive protein, but was associated with higher BMI and waist circumference. CONCLUSIONS Whole eggs are important dietary contributors of many nutrients and had either beneficial or non-significant associations with most CVD risk biomarkers examined.
Collapse
|
25
|
Liu B, Sun Y, Lehmler HJ, Bao W. Association between urinary tin concentration and diabetes in nationally representative sample of US adults. J Diabetes 2018; 10:977-983. [PMID: 29877038 PMCID: PMC6218306 DOI: 10.1111/1753-0407.12798] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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: 02/21/2018] [Revised: 05/08/2018] [Accepted: 05/29/2018] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Animal studies indicate that chronic exposure to certain tin compounds induces pancreatic islet cell apoptosis and glucose intolerance. However, little is known about the health effects of environmental tin exposure in humans. Therefore, we evaluated the association of tin exposure with diabetes in a nationally representative sample of US adults. METHODS We used data from a nationally representative population (n = 3371) in the National Health and Nutrition Examination Survey 2011-14. Diabetes (n = 605) was defined as self-reported physician's diagnosis, HbA1c ≥6.5%, fasting plasma glucose ≥126 mg/dL, or 2-h plasma glucose ≥200 mg/dL. Tin concentrations in urine samples were determined by inductively coupled plasma mass spectrometry. Logistic regression with sample weights was used to estimate the odds ratios (ORs) of diabetes and 95% confidence intervals (CIs). RESULTS Urinary tin concentrations were higher in individuals with diabetes (weighted median 0.58 μg/L) than those without diabetes (0.39 μg/L). After adjustment for urinary creatinine and other diabetes risk factors, the OR of diabetes comparing the highest with lowest quartile of urinary tin concentrations was 1.6 (95% CI 1.0-2.6; Ptrend = 0.02). CONCLUSIONS Environmental tin exposure was positively and significantly associated with diabetes in US adults.
Collapse
Affiliation(s)
- Buyun Liu
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA 52242, USA
| | - Yangbo Sun
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA 52242, USA
| | - Hans-Joachim Lehmler
- Department of Occupational and Environmental Health, College of Public Health, University of Iowa, Iowa City, IA 52242, USA
- Environmental Health Sciences Research Center, University of Iowa, Iowa City, IA 52242, USA
| | - Wei Bao
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA 52242, USA
- Environmental Health Sciences Research Center, University of Iowa, Iowa City, IA 52242, USA
- Obesity Research and Education Initiative, University of Iowa, Iowa City, IA 52242, USA
- Fraternal Order of Eagles Diabetes Research Center, University of Iowa, Iowa City, IA 52242, USA
- Center for Global and Regional Environmental Research, University of Iowa, Iowa City, IA 52242, USA
- Corresponding author: Wei Bao, MD, PhD, Department of Epidemiology, College of Public Health, University of Iowa, 145 North Riverside Drive, Room S431 CPHB, Iowa City, IA 52242; Tel: 319-384-1546; Fax: 319-384-4155;
| |
Collapse
|
26
|
Zajacova A, Montez JK. Explaining the increasing disability prevalence among mid-life US adults, 2002 to 2016. Soc Sci Med 2018; 211:1-8. [PMID: 29864712 DOI: 10.1016/j.socscimed.2018.05.041] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [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: 02/09/2018] [Revised: 05/11/2018] [Accepted: 05/24/2018] [Indexed: 12/23/2022]
Abstract
Several recent studies have documented an alarming upward trend in disability and functional limitations among US adults. In this study, we draw on the sociomedical Disablement Process framework to produce up-to-date estimates of the trends and identify key social and medical precursors of the trends. Using data on US adults aged 45-64 in the 2002-2016 National Health Interview Surveys, we estimate parametric and semiparametric models of disability and functional limitations as a function of interview time. We also determine the impact of socioeconomic resources, health behaviors, and health conditions on the trends. Our results show increasing prevalence of disability and functional limitations. These trends reflect the net result of complex countervailing forces, some associated with increases in functioning problems (unfavorable trends in economic well-being, especially income, and psychological distress) while other factors have suppressed the growth of functioning problems (favorable trends in educational attainment and some health behaviors, such as smoking and alcohol use). The results underscore that disability prevention must expand beyond medical interventions to include fundamental social factors and be focused on preventing or delaying the onset of chronic health problems and functional limitations.
Collapse
|
27
|
Abstract
Adults with higher educational attainment live healthier and longer lives compared with their less educated peers. The disparities are large and widening. We posit that understanding the educational and macrolevel contexts in which this association occurs is key to reducing health disparities and improving population health. In this article, we briefly review and critically assess the current state of research on the relationship between education and health in the United States. We then outline three directions for further research: We extend the conceptualization of education beyond attainment and demonstrate the centrality of the schooling process to health; we highlight the dual role of education as a driver of opportunity but also as a reproducer of inequality; and we explain the central role of specific historical sociopolitical contexts in which the education-health association is embedded. Findings from this research agenda can inform policies and effective interventions to reduce health disparities and improve health for all Americans.
Collapse
Affiliation(s)
- Anna Zajacova
- Department of Sociology, Western University, London, Ontario N6A 5C2, Canada;
| | | |
Collapse
|
28
|
Santos-Lozada AR, Daw J. The contribution of three dimensions of allostatic load to racial/ethnic disparities in poor/fair self-rated health. SSM Popul Health 2018; 4:55-65. [PMID: 29349273 DOI: 10.1016/j.ssmph.2017.11.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 11/14/2017] [Accepted: 11/15/2017] [Indexed: 12/22/2022] Open
Abstract
Objective This study evaluates whether different dimensions of physiological dysregulation, modeled individually rather than additively mediate racial/ethnic disparities in self-reported health. Methods Using data from the National Health and Nutrition Examination Survey (2005–2010) and the Karlson, Hold, and Breen (KHB) mediation model, this paper explores what operationalization of biomarker data most strongly mediate racial/ethnic disparities in poor/fair self-rated health (SRH) among adults in the United States, net of demographic, socioeconomic, behavioral, and medication controls. Results Non-Hispanic blacks and Hispanics had significantly higher odds of reporting poor/fair self-rated health in comparison to non-Hispanic whites. Operationalizations of allostatic load that disaggregate three major dimensions of physiological dysregulation mediate racial/ethnic disparities strongly between non-Hispanic blacks and non-Hispanic whites, but not between Hispanics and non-Hispanic whites. Disaggregating these dimensions explains racial/ethnic disparities in poor/fair SRH better than the continuous score. Analyses on sex-specific disparities indicate differences in how individual dimensions of allostatic load contribute to racial/ethnic disparities in poor/fair SRH differently. All individual dimensions are strong determinants of poor/fair SRH for males. In contrast, for females, the only dimension that is significantly associated with poor/fair SRH is inflammation. For the analytic sample, additive biomarker scores fit the data as well or better than other approaches, suggesting that this approach is most appropriate for explaining individual differences. However, in sex-specific analyses, the interactive approach models fit the data best for men and women. Conclusions Future researchers seeking to explain racial/ethnic disparities in full or sex-stratified samples should consider disaggregating allostatic load by dimension. Non-Hispanic blacks and Hispanics have higher rates of poor/fair self-rated health and levels of allostatic load Allostatic load mediates the race/ethnicity-self rated health relationship. Overall, dividing allostatic load into three dimensions better explains the white-black gap In sex-specific models interactive approaches better explain self-rated health
Collapse
|
29
|
Zajacova A, Huzurbazar S, Todd M. Gender and the structure of self-rated health across the adult life span. Soc Sci Med 2017; 187:58-66. [PMID: 28654822 DOI: 10.1016/j.socscimed.2017.06.019] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [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: 02/01/2017] [Revised: 04/21/2017] [Accepted: 06/15/2017] [Indexed: 11/24/2022]
Abstract
Despite the widespread use of self-rated health (SRH) in population health studies, the meaning of this holistic health judgment remains an open question. Gender differences in health, an issue of utmost importance in population research and policy, are often measured with SRH; the comparisons could be biased if men and women differ in how they form their health judgment. The aim of this study is to examine whether men and women differ in how health inputs predict their health rating across the adult life span. We use the 2002-2015 National Health Interview Survey data from US-born respondents aged 25-84. Ordered logistic models of SRH as a function of 24 health measures including medical conditions and symptoms, mental health, functioning, health care utilization, and health behaviors, all interacted with gender, test how the measures influence health ratings and the extent to which these influences differ by gender. Using a Bayesian approach, we then compare how closely a select health measure (K6 score) corresponds to SRH levels among men and women. We find little systematic gender difference in the structure of SRH: men and women use wide-ranging health-related frames of reference in a similar way when making health judgments, with some exceptions: mid-life and older men weigh physical functioning deficits and negative health behaviors more heavily than women. Women report worse SRH than men on average but this only holds through mid-adulthood and is reversed at older ages; moreover, the female disadvantage disappears when differences in socio-economic and health covariates are considered. Our findings suggest that the meaning of SRH is similar for women and men. Both groups use a broad range of health-related information in forming their health judgment. This conclusion strengthens the validity of SRH in measuring gender differences in health.
Collapse
|
30
|
Kollannoor-Samuel G, Shebl FM, Hawley NL, Pérez-Escamilla R. Nutrition label use is associated with lower longer-term diabetes risk in US adults. Am J Clin Nutr 2017; 105:1079-1085. [PMID: 28356273 DOI: 10.3945/ajcn.116.145359] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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: 09/14/2016] [Accepted: 03/02/2017] [Indexed: 11/14/2022] Open
Abstract
Background: Regular nutrition label use may have important long-term health implications. To our knowledge, the role of nutrition label use in protecting against the development of chronic diseases was unexplored prospectively before this study.Objective: We tested the association between nutrition label use and risk of a future diabetes diagnosis in a multiethnic US cohort.Design: Data from the ongoing National Longitudinal Survey of Youth-1979 (NLSY79) were analyzed. From 2002 (baseline) to 5 follow-up time points (2004-2012), 7150 diabetes-free, multiethnic young adults were prospectively followed for a diagnosis of incident diabetes. Nutrition label use, diabetes diagnosis, time to diabetes diagnosis, and all covariates were self-reported.Results: Between January 2002 and September 2013, 430 participants (6.0%) were diagnosed with diabetes. A weighted, multivariable, extended Cox regression was conducted, which suggested that in nutrition label users, the HR of diabetes diagnosis risk decreased significantly with time (P-nutrition label use × time interaction < 0.05) compared with risk in nutrition label nonusers.Conclusions: There is an association between nutrition label use and diabetes risk in the longer term. However, additional longitudinal research with a robust dietary intake assessment is needed to test this hypothesis.
Collapse
Affiliation(s)
| | - Fatma M Shebl
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT
| | - Nicola L Hawley
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT
| | | |
Collapse
|
31
|
Eicher-Miller HA, Boushey CJ. How Often and How Much? Differences in Dietary Intake by Frequency and Energy Contribution Vary among U.S. Adults in NHANES 2007-2012. Nutrients 2017; 9:E86. [PMID: 28124990 DOI: 10.3390/nu9010086] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2016] [Revised: 01/17/2017] [Accepted: 01/18/2017] [Indexed: 11/16/2022] Open
Abstract
The objective of this study was to determine the top frequently reported foods or beverages and the top foods or beverages grouped by broad and specific What We Eat In America (WWEIA) categories for adult age groups of 19 to 35 years, 36 to 55 years, and ≥65 years (n = 16,399) using data drawn from the cross-sectional, WWEIA, National Health And Nutrition Examination Survey (NHANES) 2007–2012 and to compare intake of broad WWEIA categories ranked by frequency and by energy contribution among these adult age groups. Ranking, unadjusted and weighted frequencies, and the proportion of reported foods or energy out of all reported foods or energy were determined and stratified by age. The Rao–Scott modified chi-square was used to test for significant differences among age groups. Results support dietary quality differences by age; intake of broad WWEIA categories was significantly different among age groups by frequency for alcohol, water, and condiment/sauces. Energy contributions significantly differed among age groups for protein foods, snacks/sweets, and beverages. Frequently reported foods and beverages may be used to inform the creation of search tools used for automatic and user-verified identification of foods and beverages in mobile- or technology-based dietary assessment.
Collapse
|
32
|
Abstract
This Short Communication builds on recent findings that documented an anomaly in the education–health gradient: adults who attended college but did not earn a BA (the subbaccalaureate group) reported an equal or higher level of health problems than adults with high school (HS) diploma. Our aim is to test whether this anomaly holds when we eliminate potential reporting differences, by examining biomarker levels in the subbaccalaureate vs HS groups. Using the restricted 1999–2012 NHANES, we estimate models of biomarkers for cardiovascular and metabolic diseases as a function of educational attainment, including three subbaccalaureate levels: “some college”, vocational associate degree (AA), and academic AA. The data show that adults with “some college” or vocational AA have no systematic advantage over HS graduates in most biomarker indices while academic AA is associated with a significantly better risk profile compared to HS. The findings indicate that the adults with some college and vocational AA degrees do not benefit from their college experience in terms of improved physiological risk profile. This pattern underscores the need to understand and explain the anomalous health pattern that concerns 28% of American adults in the subbaccalaureate group among whom many reap little health payoffs to postsecondary schooling.
Collapse
Affiliation(s)
- Anna Zajacova
- University of Wyoming, Department of Sociology, Dept. 3293, 1000 E University Ave., Laramie, WY 82071, United States
- Corresponding author.
| | | |
Collapse
|
33
|
Cui W, Kobau R, Zack MM, Buelow JM, Austin JK. Recent changes in attitudes of US adults toward people with epilepsy - Results from the 2005 SummerStyles and 2013 FallStyles surveys. Epilepsy Behav 2015; 52:108-18. [PMID: 26409138 DOI: 10.1016/j.yebeh.2015.08.040] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [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: 08/23/2015] [Accepted: 08/30/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVES This study aimed to evaluate the validity and the reliability of two components of the Attitudes and Beliefs about Living with Epilepsy (ABLE) scale and to measure the magnitude of the public's attitudes and behaviors toward persons with epilepsy using U.S. nationally representative samples in 2005 and 2013. METHODS We used data from the cross-sectional 2005 SummerStyles and 2013 FallStyles surveys to test the underlying structure of 16 items of the work and role expectations and personal fear and social avoidance subscales of ABLE by performing exploratory factor analysis (EFA). We estimated the percentages and 95% confidence intervals of adults who agreed or disagreed with each item. We also calculated the mean score of each subscale and used linear regression to obtain means adjusted for selected sociodemographic characteristics. RESULTS Exploratory factor analysis confirmed a two-factor structure, but with the exception of omitting one item regarding work activities persons with epilepsy cannot do work activities safely, from one subscale. Both subscales also showed a high level of reliability (Cronbach's α=0.8 and Cronbach's α=0.9, respectively). Among the items in the work and role expectations subscale, a significantly higher percentage of adults in 2013 than in 2005 reported strongly or moderately agreeing that persons with epilepsy can do anything as well as anyone else (56.4%, 95% CI=54.1-58.7 vs. 47.6%, 95% CI=45.8-49.3) and can cope with everyday life (69.8%, 95% CI=67.5-72.0 vs. 55.0%, 95% CI=53.2-56.7). Among the items in the personal fear and social avoidance subscale, a significantly higher percentage of adults reported in 2013 than in 2005 strongly or moderately agreeing that they would be nervous around persons with epilepsy (25.4%, 95% CI=23.4-27.5 vs. 16.8%, 95% CI=15.4-18.2) and would avoid those with frequent seizures (12.4%, 95% CI=11.0-13.9 vs. 7.6%, 95% CI=6.7-8.7). The adjusted mean score for work and role expectations differed by sex, age, race/ethnicity, education, and income in both years. The adjusted mean score for personal fear and social avoidance differed by sex, age, race/ethnicity, education, and marital status. Negative attitudes were slightly but significantly higher in 2013 than in 2005. CONCLUSIONS Centers for Disease Control and Prevention's ABLE scale is a valid and reliable scale that can be used to study and to track the public's attitudes and behaviors toward persons with epilepsy. Compared with 2005, US adults' reported level of expectations for persons with epilepsy improved only in certain aspects by 2013. Adults' level of personal fear and intention for social avoidance worsened from 2005 to 2013. Because the levels of expectations and of fear and social avoidance differed by sociodemographic characteristics, continued efforts tailored to specific groups are needed. To supplement educational programs focused on improving knowledge, new communication approaches grounded in decision theory that quell risk perceptions and allay negative emotional responses are recommended.
Collapse
Affiliation(s)
- Wanjun Cui
- Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Population Health, Epilepsy Program, 4770 Buford Highway NE, MS K-78, Atlanta, GA 30341, USA.
| | - Rosemarie Kobau
- Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Population Health, Epilepsy Program, 4770 Buford Highway NE, MS K-78, Atlanta, GA 30341, USA
| | - Matthew M Zack
- Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Population Health, Epilepsy Program, 4770 Buford Highway NE, MS K-78, Atlanta, GA 30341, USA
| | - Janice M Buelow
- Epilepsy Foundation, 8301 Professional Place East, Suite 200, Landover, MD 20785, USA
| | - Joan K Austin
- Indiana University School of Nursing, Bloomington, IN 47408, USA
| |
Collapse
|
34
|
Zajacova A, Dowd JB, Schoeni RF, Wallace RB. Employment and income losses among cancer survivors: Estimates from a national longitudinal survey of American families. Cancer 2015; 121:4425-32. [PMID: 26501494 DOI: 10.1002/cncr.29510] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [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: 11/19/2014] [Accepted: 12/15/2014] [Indexed: 11/11/2022]
Abstract
BACKGROUND Cancer presents a substantial hardship for patients and their families in multiple domains beyond health and survival. Relatively little is known about the economic impact of cancer. The authors present estimates of the aggregate effects of a cancer diagnosis on employment and income in a prospective, nationally representative sample of US adults. METHODS The authors used data from the 1990 through 2009 waves of the Panel Study of Income Dynamics, a nationally representative, prospective, population-based observational study with high-quality individual and family-level economic information. Age-adjusted, sex-stratified, individual fixed-effects regression models were used to derive estimates of the impact of cancer on employment, hours worked, individual income, and total family income. RESULTS Significant effects of cancer on all 4 outcomes were observed. The probability of a cancer patient being employed dropped by almost 10 percentage points, and hours worked declined by up to 200 hours in the first year after diagnosis. Annual labor-market earnings dropped almost 40% within 2 years after diagnosis and remained low, whereas total family income declined by 20%, although it recovered within 4 years after the diagnosis. These economic impacts on survivors were driven by effects among men; the effects among women largely were not statistically significant. CONCLUSIONS A cancer diagnosis has substantial effects on the economic well-being of affected adults and their families. With the increasing number of cancer survivors in the US population, there is a growing need for examining the long-term implications for economic well-being and ways to mitigate the economic hardship associated with cancer.
Collapse
Affiliation(s)
- Anna Zajacova
- Department of Sociology, University of Wyoming, Laramie, Wyoming
| | - Jennifer B Dowd
- CUNY School of Public Health, Hunter College, City University of New York, New York, New York
| | - Robert F Schoeni
- Institute for Social Research, School of Public Policy, and Department of Economics, University of Michigan, Ann Arbor, Michigan
| | | |
Collapse
|
35
|
Abstract
Exposure to inorganic arsenic in the general population occurs mainly from drinking water and food sources. This study examined the association between rice consumption and urinary concentrations of arsenic in US adults, aged 20-85 years, in the 2003-2006 National Health and Nutrition Examination Survey. Significantly higher geometric means of creatinine-corrected urinary concentrations of total arsenic (TAs) and dimethylarsinic acid (DMA) were found in participants who consumed rice more than twice per week, compared to the reference group. Multivariate logistic regression analysis revealed a statistically significant association between rice consumption and urinary concentrations of TAs [odds ratio (OR) = 1.51 (1.08, 2.09)] and DMA [OR = 2.24 (1.57, 3.21)] after adjustment for demographic variables, seafood intake (the main source of organic arsenic), and source of drinking water. Furthermore, significant variations in rice consumption and urinary concentrations of arsenic were observed in different racial groups. This study demonstrated that rice consumption contributed to inorganic arsenic exposure in US adults.
Collapse
Affiliation(s)
- Yudan Wei
- a Department of Community Medicine , Mercer University School of Medicine , Macon , GA , USA
| | | | | |
Collapse
|