To assess whether trends in cardiovascular disease (CVD) risk factors by among overweight and obese US adults have improved.Methods
The study included 10,568 adults 18 years and older who participated in National Health and Nutrition Examination Survey 1999-2010. CVD risk factors included diabetes (self-reported diagnosis, glycated hemoglobin ≥6.5%, or fasting plasma glucose ≥126mg/dl), hypertension (treatment or blood pressure ≥140/90 mmHg), dyslipidemia (treatment or non-HDL cholesterol ≥160 mg/dl), and smoking (self-report or cotinine levels ≥10 ng/ml). The prevalence and temporal trends of CVD risk factors for each BMI group were estimated.ResultsIn 2007-2010, the prevalence of diabetes, hypertension, and dyslipidemia was highest among obese (18.5%, 35.7%, 49.7%, respectively) followed by overweight (8.2%, 26.4%, 44.2%, respectively) and normal weight adults (5.4%, 19.8%, 28.6%, respectively). Smoking exposure was highest among normal weight (29.8%) followed by overweight (24.8%) and obese adults (24.6%). From 1999-2002 to 2007-2010, untreated hypertension decreased among obese and overweight adults and untreated dyslipidemia decreased for all weight groups. There were no significant temporal changes in smoking across BMI groups.Conclusions
Despite decreases in untreated risk factors, it is important to improve the CVD risk profile of overweight and obese US adults.
[Show abstract][Hide abstract] ABSTRACT: Objectives: Reduced Physical Activity (PA) has been implicated in the increased prevalence of adolescent obesity and Systolic Blood Pressure (SBP). The present study provides a robust examination of these relationships in Hispanic adolescents from a rural population for which data are scarce. Methods: We compared PA levels, SBP and body mass categories (normal weight, overweight and obese) between non-Hispanic white and Hispanic adolescents (15 ± 0.1 yrs; n=983 males, 911 females) using odds ratio and path analyses. Results: When groups (by gender & ethnicity) were categorized by body mass independent of SBP, prevalence of elevated SBP for obese compared to normal weight cohorts was 3.5-and 12-fold greater for non-Hispanic white males and females, respectively, and 2-and 3-fold greater for Hispanic males and females, respectively. When categorized by SBP independent of Body Mass Index (BMI), prevalence of obesity for adolescents with elevated SBP compared to normotensive cohorts was 3.5-and 6-fold greater for non-Hispanic white males and females, respectively, and 2-fold greater for both Hispanic males and females. Conclusions: Path analyses suggest that both reduced PA and increased BMI are simultaneous predictors of the observed elevation in SBP. Odds ratio analyses revealed that 6+hr PA/wk reduced the probability of developing elevated SBP 3-fold in both genders independent of body mass category or ethnicity, identifying increased PA as a critical behavioral element to target to alleviate the consequences of obesity-related increases in SBP in young people regardless of ethnicity or gender.
[Show abstract][Hide abstract] ABSTRACT: One cause of obesity and related diseases like type-2 diabetes is overconsumption of cereal foods with readily available carbohydrates, resulting in hyperglycaemia and ultimately insulin resistance. A strategy to combat this is to modulate glycaemic response through starchy cereal foods that have low glycaemic index (GI) because their starch is less available to digestion. In cereals, many factors can limit accessibility of amylase to the starch. Of these, intact pieces of endosperm, high levels of oat or barley β-glucan and high amylose starch are probably the most important. Starch accessibility in cereal foods is also greatly affected by processing. Heat-moisture thermal processing at low moisture above glass transition temperature, but below gelatinization temperature is probably the most effective processing technology to reduce starch availability. Formation of starch-lipid complexes also appears promising. Whole grain (milled whole kernel) cereal foods are intrinsically low GI but may have a long-term role in preventing obesity and type 2 diabetes through their phytochemicals, particularly polyphenols. A novel approach is to structure starchy cereal foods to deliver their carbohydrate at the distal end of the gastrointestinal tract to trigger the ileal and colonic brakes feedback systems so as to enhance satiety and hence decrease energy intake.
[Show abstract][Hide abstract] ABSTRACT: Objective:
The role of cardiovascular disease (CVD) risk factors in psoriatic arthritis (PsA) is poorly understood. We examined the prevalence of CVD risk factors at initial onset of PsA and compared the observed incidence of CVD events with that predicted by the Framingham Risk Score (FRS) to determine its applicability in this patient population.
A population-based incidence cohort of 158 patients with PsA who fulfilled Classification of Psoriatic Arthritis criteria for PsA in 1989-2008 was assembled. Medical records were reviewed to ascertain CVD risk factors and CVD events. Future risk of CVD was estimated using the FRS algorithm.
Mean age was 43.4 years (range 19-74 years), 61% were men, and 44% were obese (body mass index ≥30 kg/m(2) ). Fifty-four patients (34%) presented with ≥2 CVD risk factors at PsA incidence. Among 126 patients ages ≥30 years at PsA incidence with no prior history of CVD, 33% had an FRS ≥10%, with 11% having an FRS ≥20%, and 18 experienced a CVD event in the first 10 years of disease duration. The 10-year cumulative incidence of CVD events was 17% (95% confidence interval [95% CI] 10%-24%), almost twice as high as the predicted incidence based on the FRS (standardized incidence ratio 1.80, 95% CI 1.14-2.86; P = 0.012).
The majority of newly diagnosed PsA patients have a >10% risk of CVD within 10 years of PsA incidence. The CVD risk in these patients is higher than expected and underestimated by the FRS.
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