Trends in cardiovascular disease risk factors by obesity level in adults in the United States, NHANES 1999-2010
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.
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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.
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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.Starch - Starke 11/2014; 67(1-2). DOI:10.1002/star.201400192 · 1.40 Impact Factor
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ABSTRACT: Determine whether baseline levels and longitudinal changes in meal preparation and cleanup time are associated with changes in cardiometabolic risk factors in midlife women. Subjects were 2755 midlife women enrolled in the Study of Women's Health Across the Nation, a multi-ethnic, longitudinal cohort study. The five diagnostic components of the metabolic syndrome and meal preparation/cleanup time were assessed repeatedly across 14 years of follow-up (spanning 1996-2011) at seven U.S. sites. Mixed-effects logistic and ordered logistic models tested associations between meal preparation/cleanup time and odds of meeting criteria for metabolic syndrome and its individual diagnostic components. Women who spent more time preparing and cleaning up meals at baseline, or demonstrated greater increases in this activity, had greater increases over time in their odds of having metabolic syndrome and in the number of metabolic syndrome components for which they met criteria. Adjusted associations were observed between meal preparation/cleanup time and hypertension, impaired fasting glucose, hypertriglyceridemia, and low high-density lipoprotein cholesterol, but not abdominal obesity. In midlife women, greater meal preparation/cleanup time is associated with the development of an adverse cardiometabolic risk profile. Public health interventions should place greater emphasis on cooking healthfully, not just cooking frequently. Copyright © 2014. Published by Elsevier Inc.Preventive Medicine 12/2014; 71. DOI:10.1016/j.ypmed.2014.11.025 · 2.93 Impact Factor